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Tytuł pozycji:

Effective risk stratification in patients with moderate cardiovascular risk using albuminuria and atherosclerotic plaques in the carotid arteries.

Tytuł :
Effective risk stratification in patients with moderate cardiovascular risk using albuminuria and atherosclerotic plaques in the carotid arteries.
Autorzy :
Greve SV; aCardiovascular and Metabolic Preventive Clinic, Department of Endocrinology, Odense University Hospital bDepartment of Cardiology, Herlev University Hospital cDepartment of Diagnostic Imaging, Gentofte University Hospital dResearch Centre for Prevention and Health eDepartment of Cardiology, Gentofte University Hospital, Denmark fHypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.
Blicher MK
Sehestedt T
Gram-Kampmann EM
Rasmussen S
Vishram JK
Olsen MH
Pokaż więcej
Źródło :
Journal of hypertension [J Hypertens] 2015 Aug; Vol. 33 (8), pp. 1563-70.
Typ publikacji :
Journal Article; Research Support, Non-U.S. Gov't
Język :
English
Imprint Name(s) :
Publication: London, England : Lippincott Williams & Wilkins
Original Publication: London ; New York : Gower Academic Pub., [1983-
MeSH Terms :
Carotid Arteries*
Albuminuria/*complications
Cardiovascular Diseases/*mortality
Cardiovascular Diseases/*prevention & control
Carotid Artery Diseases/*complications
Plaque, Atherosclerotic/*complications
Adult ; Aged ; Albuminuria/physiopathology ; Blood Pressure ; Carotid Artery Diseases/physiopathology ; Creatinine/urine ; Female ; Hospitalization ; Humans ; Male ; Middle Aged ; Myocardial Infarction/epidemiology ; Myocardial Infarction/prevention & control ; Plaque, Atherosclerotic/physiopathology ; Primary Prevention ; Pulse Wave Analysis ; Risk Assessment/methods ; Risk Factors ; Stroke/epidemiology ; Stroke/prevention & control
Substance Nomenclature :
AYI8EX34EU (Creatinine)
Entry Date(s) :
Date Created: 20150624 Date Completed: 20160408 Latest Revision: 20190318
Update Code :
20210623
DOI :
10.1097/HJH.0000000000000584
PMID :
26103123
Czasopismo naukowe
Objectives: The aim of this study was to investigate whether subclinical vascular damage improved traditional risk prediction, reclassifying individuals with regard to primary prevention.
Methods: Two thousand and fifty-nine healthy individuals aged 41, 51, 61, and 71 years were divided into age, Systematic COronary Risk Evaluation (SCORE), and Framingham risk score (FRS) groups. Subclinical vascular damage was defined as carotid-femoral pulse wave velocity at least 12 m/s, and carotid atherosclerotic plaques or urine albumin/creatinine ratio (UACR) at least 90th percentile of 0.73/1.06 mg/mmol in men/women. The composite endpoint of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, and hospitalization for ischemic heart disease was recorded (n = 229).
Results: Both elevated UACR (P = 0.002) and atherosclerotic plaques (P < 0.0001) identified a subgroup of moderate SCORE risk patients and high-intermediate FRS risk patients with high risk (P = 0.04 and P = 0.001, respectively), whereas elevated carotid-femoral pulse wave velocity did not. Elevated UACR or presence of atherosclerotic plaques reclassified patients from moderate to high SCORE risk [net reclassification improvement of 6.4%; P = 0.025), or from high intermediate to high FRS risk (net reclassification improvement 8.8%; P = 0.002). Assuming primary prevention could reduce the relative cardiovascular risk by 24-27%, on the basis of actual levels of blood pressure and cholesterol, one composite endpoint could be avoided by giving primary prevention to 19 or 24 reclassified patients found by screening 52 or 104 patients with high-intermediate FRS or moderate SCORE risk, respectively.
Conclusion: Elevated UACR and presence of atherosclerotic plaques could in a potentially cost-effective manner identify patients with moderate SCORE risk or high-intermediate FRS with actual high cardiovascular risk who will benefit from primary prevention.

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