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Five-Year Residual Atherosclerotic Cardiovascular Disease Risk Prediction Model for Statin Treated Patients With Known Cardiovascular Disease

The American journal of cardiology, 2020-12, Vol.137, p.7-11 [Peer Reviewed Journal]

2020 Elsevier Inc. ;Copyright © 2020 Elsevier Inc. All rights reserved. ;2020. Elsevier Inc. ;ISSN: 0002-9149 ;EISSN: 1879-1913 ;DOI: 10.1016/j.amjcard.2020.09.043 ;PMID: 32991855

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Title:
Five-Year Residual Atherosclerotic Cardiovascular Disease Risk Prediction Model for Statin Treated Patients With Known Cardiovascular Disease
Author: Wong, Nathan D. ; Zhao, Yanglu ; Xiang, Pin ; Coll, Blai ; López, J. Antonio G.
Subjects: Acute coronary syndromes ; Aged ; Aged, 80 and over ; Alcohol use ; Algorithms ; Apolipoproteins ; Arteriosclerosis ; Atherosclerosis ; Atherosclerosis - drug therapy ; Atherosclerosis - epidemiology ; Blood pressure ; Body mass index ; Calibration ; Canada - epidemiology ; Cardiology ; Cardiovascular disease ; Cardiovascular diseases ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - prevention & control ; Carotid arteries ; Carotid artery ; Cholesterol ; Clinical trials ; Creatinine ; Diabetes ; Family medical history ; Female ; Follow-Up Studies ; Genetics ; Health risks ; Heart attacks ; Heart failure ; Hemoglobin ; Homocysteine ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use ; Lipoproteins ; Male ; Middle Aged ; Morbidity - trends ; Prediction models ; Predictions ; Risk analysis ; Risk Assessment - methods ; Risk Factors ; Sex ; Statins ; Statistical analysis ; Statistical methods ; Stroke ; Survival Rate - trends ; Triglycerides ; United States - epidemiology
Is Part Of: The American journal of cardiology, 2020-12, Vol.137, p.7-11
Description: Despite statin therapy, many patients with atherosclerotic cardiovascular disease (ASCVD) still suffer from ASCVD events. Predictors of residual ASCVD risk are not well-delineated. We aimed to develop an ASCVD risk prediction model for patients with previous ASCVD on statin use. We utilized statin-treated patients with ASCVD from the AIM-HIGH trial cohort. A 5-year risk score for subsequent ASCVD events with known ASCVD was developed using Cox regression, including potential risk factors with age, sex, and race forced in the model. Internal discrimination and calibration were evaluated. We included 3,271 patients with ASCVD (85.4% male, mean age 63.6 years, 65% on moderate- and 24% on high-intensity statin) with complete risk factor data and mean follow-up of 4.18 years. Overall, the estimated 5-year ASCVD risk was 21.1%: 10.2% of patients had a 5-year risk of >30%, and 38.8% had risk of between 20% and 30%. In the model, male sex, hemoglobin A1c, alcohol use (inversely), family history of cardiovascular disease, homocysteine, history of carotid artery disease, and lipoprotein(a) best predicted residual ASCVD risk. Niacin treatment status did not enter the model. A C-statistic of 0.59 was obtained, with the Greenwood-Nam-D'Agostino test showing excellent calibration. We developed a risk prediction risk model for predicting 5-year residual ASCVD risk in statin-treated patients with known ASCVD that may help in identifying such persons at the highest risk of recurrent events. Validation in larger samples with patients on high-intensity statin is needed.
Publisher: United States: Elsevier Inc
Language: English
Identifier: ISSN: 0002-9149
EISSN: 1879-1913
DOI: 10.1016/j.amjcard.2020.09.043
PMID: 32991855
Source: MEDLINE
ProQuest Central

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