University Of Tasmania
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Use of clinical scores in young Australian adults for prediction of atherosclerosis in middle age

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journal contribution
posted on 2023-05-21, 16:32 authored by Huynh, Q, Alison VennAlison Venn, Costan MagnussenCostan Magnussen, Yang, H, Venkataraman, P, Terry DwyerTerry Dwyer, Thomas MarwickThomas Marwick
We sought to apply a simple cardiovascular health tool not requiring laboratory tests (the Fuster-BEWAT score, FBS) to predict subclinical atherosclerosis. This study included 2657 young adults (<40 years of age). In the prognostic group (n=894, followed for 13 years until aged 40–50 years at follow-up), the primary outcome was presence of carotid plaque measured by carotid ultrasound at follow-up. Of these 894 participants, 86 (9.6%) had unilateral, and 23 participants (2.6%) had bilateral, carotid plaques at follow-up. The baseline FBS was predictive of carotid plaque at follow-up [odds ratio OR=0.86 (95% CI 0.77–0.96) per 1-SD increase in FBS], similar to prediction from Pooled Cohort Equation [PCE, OR=0.72 (0.61–0.85) per 1-SD decrease in PCE]. Risk scores at baseline predicted outcomes more strongly than those at follow-up, and did so independently of any changes over 13 years of follow-up. Similar discrimination for predicting carotid plaque after 13 years was found for both baseline FBS [C-statistic=0.68 (95% CI 0.62–0.74)] and PCE [C-statistic=0.69 (95% CI 0.63–0.75)]. Application of this FBS prognostic information to a contemporary cohort of 1763 young adults anticipates the future development of plaque in 305 (17.3%), especially in the 1494 participants (85%) with≤2 metrics of ideal health. In conclusions, FBS measured in young adulthood predicted atherosclerosis 13 years later in middle age, independent of score changes over the follow-up period, emphasizing the importance of early damage to vascular health. FBS may be a simple and feasible risk score for engaging low-risk young people with reduction of future cardiovascular risk.


Publication title

BMC Cardiovascular Disorders



Article number









Menzies Institute for Medical Research


BioMed Central Ltd.

Place of publication

United Kingdom

Rights statement

© The Author(s) 2023. This article is licensed under a Creative Commons Attribution 4.0 International International (CC BY 4.0) License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format.

Repository Status

  • Open

Socio-economic Objectives

Prevention of human diseases and conditions