The prediction of cardiovascular events is improved by combination of Framingham risk score and subclinical atherosclerosis imaging

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State: Public
Version: author
Serval ID
serval:BIB_31F63E4937E5
Type
Inproceedings: an article in a conference proceedings.
Publication sub-type
Abstract (Abstract): shot summary in a article that contain essentials elements presented during a scientific conference, lecture or from a poster.
Collection
Publications
Institution
Title
The prediction of cardiovascular events is improved by combination of Framingham risk score and subclinical atherosclerosis imaging
Title of the conference
ESC Congress 2010, 28 August-1 September 2010, Stockholm
Author(s)
Depairon Michèle, Stauffer Iris, Berthoud Maud, Mazzolai Lucia, Marques-Vidal Pedro Manuel, Darioli Roger
ISBN
0195-668X (print,1522-9645)
ISSN-L
0195-668X
Publication state
Published
Issued date
2010
Volume
31
Series
European Heart Journal
Pages
810-811
Language
english
Notes
[Poster P4692]
Abstract
Purpose: In primary prevention of cardiovascular disease (CVD), it is accepted that the intensity of risk factor treatment should be guided by the magnitude of absolute risk. Risk factors tools like Framingham risk score (FHS) or noninvasive atherosclerosis imaging tests are available to detect high risk subjects. However, these methods are imperfect and may misclassify a large number of individuals. The purpose of this prospective study was to evaluate whether the prediction of future cardiovascular events (CVE) can be improved when subclinical imaging atherosclerosis (SCATS) is combined with the FRS in asymptomatic subjects.
Methods: Overall, 1038 asymptomatic subjects (413 women, 625 men, mean age 49.1±12.8 years) were assessed for their cardiovascular risk using the FRS. B-mode ultrasonography on carotid and femoral arteries was performed by two investigators to detect atherosclerotic plaques (focal thickening of intima-media > 1.2 mm) and to measure carotid intima-media thickness (C-IMT). The severity of SCATS was expressed by an ATS-burden Score (ABS) reflecting the number of the arterial sites with >1 plaques (range 0-4). CVE were defined as fatal or non fatal acute coronary syndrome, stroke, or angioplasty for peripheral artery disease.
Results: during a mean follow-up of 4.9±3.1 years, 61 CVE were recorded. Event rates the rate of CVE increased significantly from 2.7% to 39.1% according to the ABS (p<0.001) and from 4% to 24.6% according to the quartiles of C-IMT. Similarly, FRS predicted CVE (p<0.001). When computing the angiographic markers of SCATS in addition of FRS, we observed an improvement of net reclassification rate of 16.6% (p< 0.04) for ABS as compared to 5.5% (p = 0.26) for C-IMT.
Conclusion: these results indicate that the detection of subjects requiring more attention to prevent CVE can be significantly improved when using both FRS and SCATS imaging.
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03/03/2011 14:55
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20/08/2019 13:17
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