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Carotid ultrasound and systematic coronary risk assessment 2 in the prediction of cardiovascular events

Bao, Xue (author)
Lund University,Lunds universitet,Kardiovaskulär forskning - epidemiologi,Forskargrupper vid Lunds universitet,Cardiovascular Research - Epidemiology,Lund University Research Groups,Nanjing University
Xu, Biao (author)
Nanjing Univ, Nanjing Drum Tower Hosp, Dept Cardiol, Affiliated Hosp,Med Sch, 321 Zhongshan Rd, Nanjing 210008, Peoples R China.,Nanjing University
Lind, Lars (author)
Uppsala University,Uppsala universitet,Klinisk epidemiologi
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Engström, Gunnar (author)
Lund University,Lunds universitet,Kardiovaskulär forskning - epidemiologi,Forskargrupper vid Lunds universitet,Cardiovascular Research - Epidemiology,Lund University Research Groups
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 (creator_code:org_t)
Oxford University Press, 2023
2023
English.
In: European Journal of Preventive Cardiology. - : Oxford University Press. - 2047-4873 .- 2047-4881. ; 30:10, s. 1007-1014
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • AimsSubclinical carotid atherosclerosis adds predictive value to traditional risk factors for cardiovascular diseases (CVDs). Systematic Coronary Risk Assessment 2 (SCORE2), an algorithm composed of traditional risk factors, is a state-of-the-art to estimate the 10-year risk of first-onset CVDs. We aim to investigate whether and how subclinical carotid atherosclerosis affects the performance of SCORE2.Methods and resultsCarotid plaque presence and intima media thickness (IMT) were measured with ultrasound. The SCORE2 was calculated in 4588 non-diabetic participants aged 46–68 years. The incremental value for predicting CVD events of adding carotid plaque or IMT to SCORE2 was evaluated using C-statistics, continuous net reclassification improvement (NRI), and integrated discrimination improvement (IDI). The predicted 10-year CVD risk by SCORE2 and the observed event rate were compared between participants with and without carotid plaque. Adding plaque or IMT to SCORE2 significantly improved performance for predicting CVDs. The improvements in C-statistics, IDI, and NRI of adding plaque to SCORE2 for events occurring during the first 10 years were 2.20%, 0.70%, and 46.1%, respectively (all P < 0.0001). The SCORE2 over-predicted the 10-year CVD risk in those without carotid plaque (3.93% observed vs. 5.89% predicted, P < 0.0001) while under-predicted the risk in those with carotid plaque (9.69% observed vs. 8.12% predicted, P = 0.043).ConclusionCarotid ultrasound adds predictive performance to SCORE2 for assessment of CVD risk. Using SCORE2 without considering carotid atherosclerosis could under- or over-estimate the risk.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Keyword

SCORE2
Carotid plaque
Intima media thickness
Cohort
Carotid plaque
Cohort
Intima media thickness
SCORE2

Publication and Content Type

ref (subject category)
art (subject category)

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By the author/editor
Bao, Xue
Xu, Biao
Lind, Lars
Engström, Gunnar
About the subject
MEDICAL AND HEALTH SCIENCES
MEDICAL AND HEAL ...
and Clinical Medicin ...
and Cardiac and Card ...
Articles in the publication
European Journal ...
By the university
Uppsala University
Lund University

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