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

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posted on 2023-05-21, 16:32 authored by Huynh, Q, Alison VennAlison Venn, Costan 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.

History

Publication title

BMC Cardiovascular Disorders

Volume

23

Article number

63

Number

63

Pagination

1-10

ISSN

1471-2261

Department/School

Menzies Institute for Medical Research

Publisher

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, https://creativecommons.org/licenses/by/4.0/ 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

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