Cardiovascular disease risk categories based on SCORE algorithms and age: reclassification based on number of carotid and common femoral bifurcations with plaque.
Andrew N Nicolaides, Andrie G Panayiotou, Maura B Griffin, Theodosis Tyllis, Efthyvoulos Kyriacou, Costantinos Avraamides, Despo Ierodiakonou, Christiana A Demetriou, Richard M Martin
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引用次数: 0
Abstract
Background: The aim was to determine the efficacy of the number of carotid and common femoral bifurcations with plaque (NBP) detected by ultrasound in reclassifying individuals into atherosclerotic cardiovascular disease (ASCVD) risk categories based on SCORE2, SCORE2-OP algorithms and age. Data from the cohort of 908 individuals free from ASCVD and diabetes in the Cyprus Epidemiological Study on Atherosclerosis (CESA) was used.
Methods: In each predicted ASCVD risk category (low to moderate, high and very high) the observed 10-year risk of subgroups according to the NBP was used to reclassify participants.
Results: There were 183 ASCVD events during a mean follow-up of 15.5±4.6 years. The observed 10-year event rate was 4% in the low to moderate risk category, 7% in the high-risk category and 21% in the very high-risk category. The presence of more than one bifurcation with plaque up-classified 41 (16%) participants from the low to moderate category to a high-risk group (observed 10-year risk of 12%) with adjusted to SCORE2 and SCORE2-OP hazard ratio of 5.21 (95% CI 2.18 to 17.69) and 130 (40%) participants from the high-risk category to a very high-risk group (observed 10-year risk of 17%) with hazard ratio of 4.52 (95% CI 2.35 to 8.69).
Conclusions: Because ultrasound is relatively inexpensive, and because ascertaining the presence of plaque in four superficial arterial bifurcations is a much easier and less time-consuming method than measurements of plaque thickness, area, or volume, this method has the potential for a practical clinical application.
背景：目的是确定超声检测的颈动脉和股总分叉斑块（NBP）数量在基于SCORE2、SCORE2- op算法和年龄将个体重新划分为动脉粥样硬化性心血管疾病（ASCVD）风险类别中的有效性。数据来自塞浦路斯动脉粥样硬化流行病学研究（CESA） 908名无ASCVD和糖尿病患者。方法：在每一个预测的ASCVD风险类别（低到中等，高和非常高）中，根据NBP观察到的10年亚组风险对参与者进行重新分类。结果：在平均15.5±4.6年的随访期间，共发生183例ASCVD事件。观察到的10年事件发生率在低至中度风险类别中为4%，在高风险类别中为7%，在非常高风险类别中为21%。存在一个以上的斑块分叉，将41名（16%）参与者从低到中等类别分类为高风险组（观察到的10年风险为12%），调整后的SCORE2和SCORE2- op风险比为5.21 (95% CI 2.18至17.69)，130名（40%）参与者从高风险类别分类为非常高风险组（观察到的10年风险为17%），风险比为4.52 （95% CI 2.35至8.69）。结论：由于超声相对便宜，并且与测量斑块厚度、面积或体积相比，确定四个浅动脉分叉斑块的存在更容易，更省时，因此该方法具有实际临床应用的潜力。
期刊介绍：
International Angiology publishes scientific papers on angiology. Manuscripts may be submitted in the form of editorials, original articles, review articles, special articles, letters to the Editor and guidelines. The journal aims to provide its readers with papers of the highest quality and impact through a process of careful peer review and editorial work. Duties and responsibilities of all the subjects involved in the editorial process are summarized at Publication ethics. Manuscripts are expected to comply with the instructions to authors which conform to the Uniform Requirements for Manuscripts Submitted to Biomedical Editors by the International Committee of Medical Journal Editors (ICMJE).
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