Skip to main content
Top
Published in: The International Journal of Cardiovascular Imaging 10/2017

01-10-2017 | Original Paper

Association between cardiovascular disease risk scores and subclinical atherosclerosis prevalence in non-elderly adult patients from Argentina

Authors: Ricardo A. Albertini, Dario G. Ferrer, Pablo A. Romagnoli, María E. Tinti, José L. Amigone, Raúl Capra, Gustavo A. Chiabrando

Published in: The International Journal of Cardiovascular Imaging | Issue 10/2017

Login to get access

Abstract

The goal of our study was to use statistical analysis to try to associate cardiovascular disease (CVD) risk scores and the observed prevalence of subclinical atherosclerosis (SA) in a non-elderly adult local population. An observational cross-sectional study was carried out (143 male and 131 female) on non-elderly adults (20–59 years). CVD risk scores included Framingham Risk Scores for 10-year hard (FRS 10 H), 30-year lipid hard or CVD (FRS 30 L H or FRS 30 L CVD), 30 year-body mass index hard or CVD (FRS 30 BMI H or FRS 30 BMI CVD) and Pooled Cohort Risk Equations for either 10 years (PCE 10) or lifetime (PCE LT). The Carotid Ultrasound (CU) study was performed and the Coronary Artery Calcium (CAC) score were obtained to assess SA. The Receiving Operating Characteristic (ROC) curve analysis followed by Youden’s index was used to evaluate and adjust the stratification of CVD risk scores. SA was detected in 32.4% of individuals. The risk scores that showed the biggest areas under the ROC curve were FRS 30 L (H and CVD). When the cut-off values for these CVD risk scores were adjusted, the FRS 30 L H increased the negative predictive value for the low risk group from 87.7 to 97.0% and the FRS 30 L CVD increased the positive predictive values for the high risk group from 69.7 to 85.7%. The CVD risk stratification of non-elderly adults using FRS 30 L H and FRS 30 L CVD may be a useful tool for selecting candidate patients for diagnostic imaging studies that assess their SA prevalence.
Appendix
Available only for authorised users
Literature
1.
go back to reference Collaborators GMaCoD (2015) Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet 385(9963):117–171. doi:10.1016/S0140-6736(14)61682-2 CrossRef Collaborators GMaCoD (2015) Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet 385(9963):117–171. doi:10.​1016/​S0140-6736(14)61682-2 CrossRef
2.
go back to reference Nación MdSdl (2015) Estadísticas vitales. Información básica año 2014. vol 5. Nación MdSdl (2015) Estadísticas vitales. Información básica año 2014. vol 5.
4.
go back to reference Expert Panel on Detection Ea, and Treatment of High Blood Cholesterol in Adults (2001) Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA 285 (19):2486–2497CrossRef Expert Panel on Detection Ea, and Treatment of High Blood Cholesterol in Adults (2001) Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA 285 (19):2486–2497CrossRef
6.
go back to reference Goff DC, Lloyd-Jones DM, Bennett G, Coady S, D’Agostino RB, Gibbons R, Greenland P, Lackland DT, Levy D, O’Donnell CJ, Robinson JG, Schwartz JS, Shero ST, Smith SC, Sorlie P, Stone NJ, Wilson PW, Guidelines ACoCAHATFoP (2014) 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 63(25 Pt B):2935–2959. doi:10.1016/j.jacc.2013.11.005 CrossRefPubMed Goff DC, Lloyd-Jones DM, Bennett G, Coady S, D’Agostino RB, Gibbons R, Greenland P, Lackland DT, Levy D, O’Donnell CJ, Robinson JG, Schwartz JS, Shero ST, Smith SC, Sorlie P, Stone NJ, Wilson PW, Guidelines ACoCAHATFoP (2014) 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 63(25 Pt B):2935–2959. doi:10.​1016/​j.​jacc.​2013.​11.​005 CrossRefPubMed
7.
go back to reference Goff DC Jr., Lloyd-Jones DM, Bennett G, Coady S, D’Agostino RB, Gibbons R, Greenland P, Lackland DT, Levy D, O’Donnell CJ, Robinson JG, Schwartz JS, Shero ST, Smith SC Jr., Sorlie P, Stone NJ, Wilson PW, Jordan HS, Nevo L, Wnek J, Anderson JL, Halperin JL, Albert NM, Bozkurt B, Brindis RG, Curtis LH, DeMets D, Hochman JS, Kovacs RJ, Ohman EM, Pressler SJ, Sellke FW, Shen WK, Smith SC Jr., Tomaselli GF, American College of Cardiology/American Heart Association Task Force on Practice G (2014) 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 129(25 Suppl 2):S49–73. doi:10.1161/01.cir.0000437741.48606.98 CrossRefPubMed Goff DC Jr., Lloyd-Jones DM, Bennett G, Coady S, D’Agostino RB, Gibbons R, Greenland P, Lackland DT, Levy D, O’Donnell CJ, Robinson JG, Schwartz JS, Shero ST, Smith SC Jr., Sorlie P, Stone NJ, Wilson PW, Jordan HS, Nevo L, Wnek J, Anderson JL, Halperin JL, Albert NM, Bozkurt B, Brindis RG, Curtis LH, DeMets D, Hochman JS, Kovacs RJ, Ohman EM, Pressler SJ, Sellke FW, Shen WK, Smith SC Jr., Tomaselli GF, American College of Cardiology/American Heart Association Task Force on Practice G (2014) 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 129(25 Suppl 2):S49–73. doi:10.​1161/​01.​cir.​0000437741.​48606.​98 CrossRefPubMed
8.
go back to reference Cortes-Bergoderi M, Thomas RJ, Albuquerque FN, Batsis JA, Burdiat G, Perez-Terzic C, Trejo-Gutierrez J, Lopez-Jimenez F (2012) Validity of cardiovascular risk prediction models in Latin America and among Hispanics in the United States of America: a systematic review. Rev Panam Salud Publica 32 (2):131–139CrossRefPubMed Cortes-Bergoderi M, Thomas RJ, Albuquerque FN, Batsis JA, Burdiat G, Perez-Terzic C, Trejo-Gutierrez J, Lopez-Jimenez F (2012) Validity of cardiovascular risk prediction models in Latin America and among Hispanics in the United States of America: a systematic review. Rev Panam Salud Publica 32 (2):131–139CrossRefPubMed
10.
go back to reference Burke GL, Evans GW, Riley WA, Sharrett AR, Howard G, Barnes RW, Rosamond W, Crow RS, Rautaharju PM, Heiss G (1995) Arterial wall thickness is associated with prevalent cardiovascular disease in middle-aged adults. The Atherosclerosis Risk in Communities (ARIC) study. Stroke 26(3):386–391CrossRefPubMed Burke GL, Evans GW, Riley WA, Sharrett AR, Howard G, Barnes RW, Rosamond W, Crow RS, Rautaharju PM, Heiss G (1995) Arterial wall thickness is associated with prevalent cardiovascular disease in middle-aged adults. The Atherosclerosis Risk in Communities (ARIC) study. Stroke 26(3):386–391CrossRefPubMed
11.
go back to reference Bots ML, Hoes AW, Koudstaal PJ, Hofman A, Grobbee DE (1997) Common carotid intima-media thickness and risk of stroke and myocardial infarction: the Rotterdam study. Circulation 96(5):1432–1437CrossRefPubMed Bots ML, Hoes AW, Koudstaal PJ, Hofman A, Grobbee DE (1997) Common carotid intima-media thickness and risk of stroke and myocardial infarction: the Rotterdam study. Circulation 96(5):1432–1437CrossRefPubMed
12.
go back to reference Arad Y, Spadaro LA, Goodman K, Lledo-Perez A, Sherman S, Lerner G, Guerci AD (1996) Predictive value of electron beam computed tomography of the coronary arteries. 19-month follow-up of 1173 asymptomatic subjects. Circulation 93(11):1951–1953CrossRefPubMed Arad Y, Spadaro LA, Goodman K, Lledo-Perez A, Sherman S, Lerner G, Guerci AD (1996) Predictive value of electron beam computed tomography of the coronary arteries. 19-month follow-up of 1173 asymptomatic subjects. Circulation 93(11):1951–1953CrossRefPubMed
13.
go back to reference Detrano R, Guerci AD, Carr JJ, Bild DE, Burke G, Folsom AR, Liu K, Shea S, Szklo M, Bluemke DA, O’Leary DH, Tracy R, Watson K, Wong ND, Kronmal RA (2008) Coronary calcium as a predictor of coronary events in four racial or ethnic groups. N Engl J Med 358(13):1336–1345. doi:10.1056/NEJMoa072100 CrossRefPubMed Detrano R, Guerci AD, Carr JJ, Bild DE, Burke G, Folsom AR, Liu K, Shea S, Szklo M, Bluemke DA, O’Leary DH, Tracy R, Watson K, Wong ND, Kronmal RA (2008) Coronary calcium as a predictor of coronary events in four racial or ethnic groups. N Engl J Med 358(13):1336–1345. doi:10.​1056/​NEJMoa072100 CrossRefPubMed
15.
go back to reference National Institutes of Health (1998) Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults–the evidence report. Obes Res 6(Suppl 2):51S–209S National Institutes of Health (1998) Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults–the evidence report. Obes Res 6(Suppl 2):51S–209S
17.
go back to reference Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, Albus C, Benlian P, Boysen G, Cifkova R, Deaton C, Ebrahim S, Fisher M, Germano G, Hobbs R, Hoes A, Karadeniz S, Mezzani A, Prescott E, Ryden L, Scherer M, Syvanne M, Scholte op Reimer WJ, Vrints C, Wood D, Zamorano JL, Zannad F, European Association for Cardiovascular P, Rehabilitation, Guidelines ESCCfP (2012) European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur Heart J 33(13):1635–1701. doi:10.1093/eurheartj/ehs092 CrossRefPubMed Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, Albus C, Benlian P, Boysen G, Cifkova R, Deaton C, Ebrahim S, Fisher M, Germano G, Hobbs R, Hoes A, Karadeniz S, Mezzani A, Prescott E, Ryden L, Scherer M, Syvanne M, Scholte op Reimer WJ, Vrints C, Wood D, Zamorano JL, Zannad F, European Association for Cardiovascular P, Rehabilitation, Guidelines ESCCfP (2012) European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur Heart J 33(13):1635–1701. doi:10.​1093/​eurheartj/​ehs092 CrossRefPubMed
18.
go back to reference Li R, Duncan BB, Metcalf PA, Crouse JR, Sharrett AR, Tyroler HA, Barnes R, Heiss G (1994) B-mode-detected carotid artery plaque in a general population. Atherosclerosis Risk in Communities (ARIC) Study Investigators. Stroke 25(12):2377–2383CrossRefPubMed Li R, Duncan BB, Metcalf PA, Crouse JR, Sharrett AR, Tyroler HA, Barnes R, Heiss G (1994) B-mode-detected carotid artery plaque in a general population. Atherosclerosis Risk in Communities (ARIC) Study Investigators. Stroke 25(12):2377–2383CrossRefPubMed
19.
go back to reference Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M, Detrano R (1990) Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 15(4):827–832CrossRefPubMed Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M, Detrano R (1990) Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 15(4):827–832CrossRefPubMed
22.
go back to reference Jiménez-Corona A, López-Ridaura R, Williams K, González-Villalpando ME, Simón J, González-Villalpando C (2009) Applicability of Framingham risk equations for studying a low-income Mexican population. Salud Publica Mex 51(4):298–305CrossRefPubMed Jiménez-Corona A, López-Ridaura R, Williams K, González-Villalpando ME, Simón J, González-Villalpando C (2009) Applicability of Framingham risk equations for studying a low-income Mexican population. Salud Publica Mex 51(4):298–305CrossRefPubMed
23.
go back to reference Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB, Bravata DM, Dai S, Ford ES, Fox CS, Franco S, Fullerton HJ, Gillespie C, Hailpern SM, Heit JA, Howard VJ, Huffman MD, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Magid D, Marcus GM, Marelli A, Matchar DB, McGuire DK, Mohler ER, Moy CS, Mussolino ME, Nichol G, Paynter NP, Schreiner PJ, Sorlie PD, Stein J, Turan TN, Virani SS, Wong ND, Woo D, Turner MB, Subcommittee AHASCaSS (2013) Executive summary: heart disease and stroke statistics–2013 update: a report from the American Heart Association. Circulation 127(1):143–152. doi:10.1161/CIR.0b013e318282ab8f CrossRefPubMed Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB, Bravata DM, Dai S, Ford ES, Fox CS, Franco S, Fullerton HJ, Gillespie C, Hailpern SM, Heit JA, Howard VJ, Huffman MD, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Magid D, Marcus GM, Marelli A, Matchar DB, McGuire DK, Mohler ER, Moy CS, Mussolino ME, Nichol G, Paynter NP, Schreiner PJ, Sorlie PD, Stein J, Turan TN, Virani SS, Wong ND, Woo D, Turner MB, Subcommittee AHASCaSS (2013) Executive summary: heart disease and stroke statistics–2013 update: a report from the American Heart Association. Circulation 127(1):143–152. doi:10.​1161/​CIR.​0b013e318282ab8f​ CrossRefPubMed
25.
26.
go back to reference Petisco AC, Assef JE, de Jesus CA, Saleh MH, Barbosa JE, Le Bihan DCDS, Pinto IM, Pedra SRFF, Barretto RB, Sousa AG (2016) High prevalence of subclinical atherosclerosis in Brazilian postmenopausal women with low and intermediate risk by Framingham score. Int J Cardiovasc Imaging. doi:10.1007/s10554-016-1002-1 Petisco AC, Assef JE, de Jesus CA, Saleh MH, Barbosa JE, Le Bihan DCDS, Pinto IM, Pedra SRFF, Barretto RB, Sousa AG (2016) High prevalence of subclinical atherosclerosis in Brazilian postmenopausal women with low and intermediate risk by Framingham score. Int J Cardiovasc Imaging. doi:10.​1007/​s10554-016-1002-1
27.
go back to reference Masson W, Siniawski D, Krauss J, Cagide A (2011) Clinical applicability of the framingham 30-year risk score. Usefulness in cardiovascular risk stratification and the diagnosis of carotid atherosclerotic plaque. Rev Esp Cardiol 64(4):305–311. doi:10.1016/j.recesp.2010.11.006 CrossRefPubMed Masson W, Siniawski D, Krauss J, Cagide A (2011) Clinical applicability of the framingham 30-year risk score. Usefulness in cardiovascular risk stratification and the diagnosis of carotid atherosclerotic plaque. Rev Esp Cardiol 64(4):305–311. doi:10.​1016/​j.​recesp.​2010.​11.​006 CrossRefPubMed
28.
go back to reference Berry JD, Liu K, Folsom AR, Lewis CE, Carr JJ, Polak JF, Shea S, Sidney S, O’Leary DH, Chan C, Lloyd-Jones DM (2009) Prevalence and progression of subclinical atherosclerosis in younger adults with low short-term but high lifetime estimated risk for cardiovascular disease: the coronary artery risk development in young adults study and multi-ethnic study of atherosclerosis. Circulation 119(3):382–389. doi:10.1161/CIRCULATIONAHA.108.800235 CrossRefPubMedPubMedCentral Berry JD, Liu K, Folsom AR, Lewis CE, Carr JJ, Polak JF, Shea S, Sidney S, O’Leary DH, Chan C, Lloyd-Jones DM (2009) Prevalence and progression of subclinical atherosclerosis in younger adults with low short-term but high lifetime estimated risk for cardiovascular disease: the coronary artery risk development in young adults study and multi-ethnic study of atherosclerosis. Circulation 119(3):382–389. doi:10.​1161/​CIRCULATIONAHA.​108.​800235 CrossRefPubMedPubMedCentral
29.
Metadata
Title
Association between cardiovascular disease risk scores and subclinical atherosclerosis prevalence in non-elderly adult patients from Argentina
Authors
Ricardo A. Albertini
Dario G. Ferrer
Pablo A. Romagnoli
María E. Tinti
José L. Amigone
Raúl Capra
Gustavo A. Chiabrando
Publication date
01-10-2017
Publisher
Springer Netherlands
Published in
The International Journal of Cardiovascular Imaging / Issue 10/2017
Print ISSN: 1569-5794
Electronic ISSN: 1875-8312
DOI
https://doi.org/10.1007/s10554-017-1152-9

Other articles of this Issue 10/2017

The International Journal of Cardiovascular Imaging 10/2017 Go to the issue