CBS 2019
CBSMD教育中心
English

推荐文献

科研文章

荐读文献

Association of Body Mass Index With Lifetime Risk of Cardiovascular Disease and Compression of Morbidity Mode of Death in Heart Failure With Preserved Ejection Fraction Hs-cTroponins for the prediction of recurrent cardiovascular events in patients with established CHD - A comparative analysis from the KAROLA study 2016 ACC/AHA/HFSA Focused Update on New Pharmacological Therapy for Heart Failure: An Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Validation of High-Risk Features for Stent-Related Ischemic Events as Endorsed by the 2017 DAPT Guidelines Interleukin-1 Beta as a Target for Atherosclerosis Therapy: Biological Basis of CANTOS and Beyond Left Ventricular Assist Devices for Lifelong Support Routinely reported ejection fraction and mortality in clinical practice: where does the nadir of risk lie? A Randomized Trial Comparing the NeoVas Sirolimus-Eluting Bioresorbable Scaffold and Metallic Everolimus-Eluting Stents 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society
|<<... 5 6 7 8 9 10 11 ...>>|

Original Research30 Jul 2018 [Epub ahead]

JOURNAL：Circulation. Article Link

The Astronaut Cardiovascular Health and Risk Modification (Astro-CHARM) Coronary Calcium Atherosclerotic Cardiovascular Disease Risk Calculator

A Khera , MJ Budoff , CJ O’Donnell et al. Keywords: coronary artery calcium; risk prediction

ABSTRACT

BACKGROUND - Coronary artery calcium (CAC) is a powerful novel risk indicator for atherosclerotic cardiovascular disease (ASCVD). Currently, there is no available ASCVD risk prediction tool that integrates traditional risk factors and CAC.


METHODS - To develop a CAC ASCVD risk tool for younger individuals in the general population, subjects aged 40-65 without prior CVD from three population-based cohorts were included. Cox proportional hazards models were developed incorporating age, sex, systolic blood pressure, total and HDL cholesterol, smoking, diabetes, hypertension treatment, family history of MI, high-sensitivity CRP (hs-CRP), and CAC scores (Astro-CHARM model) as dependent variables and ASCVD (non-fatal/fatal MI or stroke) as the outcome. Model performance was assessed internally, and validated externally in a fourth cohort.

RESULTS - The derivation study comprised 7382 individuals with mean age 51 years, 45% female, and 55% non-white. The median CAC was 0 (25-75th [0,9]) and 304 ASCVD events occurred in median 10.9 years of follow-up. The c-statistic was 0.784 for the risk factor model, and 0.817 for Astro-CHARM (p<0.0001). Compared with the risk factor model, the Astro-CHARM model resulted in integrated discrimination improvement (IDI=0.0252) as well as net reclassification improvement (NRI=0.121, p<0.0001). The Astro-CHARM model demonstrated good discrimination (c=0.78) and calibration (Nam-D’Agostino χ2:13.2, p=0.16) in the validation cohort (n=2057; 55 events). A mobile application and web-based tool were developed to facilitate clinical application of this tool ( www.AstroCHARM.org).

CONCLUSIONS - The Astro-CHARM tool is the first integrated ASCVD risk calculator to incorporate risk factors, including hs-CRP and family history, and CAC data. It improves risk prediction compared with traditional risk factor equations and could be useful in risk-based decision making for CV disease prevention in the middle-aged general population.
>CBS CBS 2019

> CBS 2019

> CBS 2019 注册

> CBS 2019 会议日程

> CBS 2019 学术征集

> CBS 2019 热点

 CBSMD

> CBSMD 网站注册

> 教育中心

> 荐读文献

> Top 10 阅读文献

> 文献导读
CBS 2019 CBS 2019 主席团 教育中心 科研动态
Copyright ⓒ CBS MD Nanjing China. All rights reserved. 京ICP备16025898号-11
联系我们| Top