2010 ACCF/AHA Guideline for Assessment of Cardiovascular Risk in Asymptomatic Adults

Greenland, Philip; Alpert, Joseph S.; Beller, George A.; Benjamin, Emelia J.; Budoff, Matthew J.; Fayad, Zahi A.; Foster, Elyse; Hlatky, Mark A.; Hodgson, John Mc B.; Kushner, Frederick G.; Lauer, Michael S.; Shaw, Leslee J.; Smith, Sidney C.; Taylor, Allen J.; Weintraub, William S.; Wenger, Nanette K.

doi:10.1016/j.jacc.2010.09.001

Cited by 1,174 publications

(461 citation statements)

References 457 publications

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“…Identification of additional risk factors and evaluation of their contribution to CVD is necessary to both to improve our prediction strategies, based mainly on traditional risk factors, and to better tailor preventive interventions at the individual and population levels 37. Results of noninvasive vascular imaging techniques have been shown to improve cardiovascular risk prediction 38.…”

Section: Discussionmentioning

confidence: 99%

Prediction of Cardiovascular Disease by the Framingham‐REGICOR Equation in the High‐Risk PREDIMED Cohort: Impact of the Mediterranean Diet Across Different Risk Strata

Amor

Serra‐Mir

Martínez‐González

et al. 2017

JAHA

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BackgroundThe usefulness of cardiovascular disease (CVD) predictive equations in different populations is debatable. We assessed the efficacy of the Framingham‐REGICOR scale, validated for the Spanish population, to identify future CVD in participants, who were predefined as being at high‐risk in the PREvención con DIeta MEDiterránea (PREDIMED) study—a nutrition‐intervention primary prevention trial—and the impact of adherence to the Mediterranean diet on CVD across risk categories.Methods and ResultsIn a post hoc analysis, we assessed the CVD predictive value of baseline estimated risk in 5966 PREDIMED participants (aged 55–74 years, 57% women; 48% with type 2 diabetes mellitus). Major CVD events, the primary PREDIMED end point, were an aggregate of myocardial infarction, stroke, and cardiovascular death. Multivariate‐adjusted Cox regression was used to calculate hazard ratios for major CVD events and effect modification from the Mediterranean diet intervention across risk strata (low, moderate, high, very high). The Framingham‐REGICOR classification of PREDIMED participants was 25.1% low risk, 44.5% moderate risk, and 30.4% high or very high risk. During 6‐year follow‐up, 188 major CVD events occurred. Hazard ratios for major CVD events increased in parallel with estimated risk (2.68, 4.24, and 6.60 for moderate, high, and very high risk), particularly in men (7.60, 13.16, and 15.85, respectively, versus 2.16, 2.28, and 3.51, respectively, in women). Yet among those with low or moderate risk, 32.2% and 74.3% of major CVD events occurred in men and women, respectively. Mediterranean diet adherence was associated with CVD risk reduction regardless of risk strata (P>0.4 for interaction).ConclusionsIncident CVD increased in parallel with estimated risk in the PREDIMED cohort, but most events occurred in non–high‐risk categories, particularly in women. Until predictive tools are improved, promotion of the Mediterranean diet might be useful to reduce CVD independent of baseline risk.Clinical Trial Registration URL: http://www.Controlled-trials.com. Unique identifier: ISRCTN35739639.

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Section: Discussionmentioning

confidence: 99%

Prediction of Cardiovascular Disease by the Framingham‐REGICOR Equation in the High‐Risk PREDIMED Cohort: Impact of the Mediterranean Diet Across Different Risk Strata

Amor

Serra‐Mir

Martínez‐González

et al. 2017

JAHA

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“…Carotid IMT progression is a validated surrogate marker of cardiovascular disease; an association between slowing of increases in the carotid IMT and a reduction in the incidence of cardiovascular disease has been reported in many studies 12,13) . Numerous meta-analyses of primary prevention studies using statins have clearly demonstrated that these drugs provide cardiovascular benefits [14][15][16] .…”

Section: Discussionmentioning

confidence: 99%

Can Intensive Lipid-Lowering Therapy Improve the Carotid Intima-Media Thickness in Japanese Subjects Under Primary Prevention for Cardiovascular Disease?: The JART and JART Extension Subanalysis

Daida

Nohara

Hata

et al. 2014

JAT

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Aim: This subanalysis aimed to clarify whether intensive lipid-lowering therapy with statins slows the progression of atherosclerosis in Japanese subjects under treatment for primary prevention of cardiovascular disease. Methods: This was a subanalysis of the Justification for Atherosclerosis Regression Treatment (JART) Study. We compared the efficacy of intensive lipid-lowering therapy and conventional therapy with respect to changes in the mean intima-media thickness (IMT) and serum lipid levels. We also evaluated changes in the mean IMT over 24 months of treatment and assessed the relationship between these changes and reductions in the LDL-C levels using a post-hoc analysis. Results: Intensive lipid-lowering therapy with rosuvastatin was associated with significantly smaller changes in the mean IMT and a greater reduction in the serum lipid levels in comparison to conventional therapy with pravastatin. The average net change in the mean IMT was 0.010 mm (n = 121) at 12 months and −0.004 mm (n = 56) at 24 months. A decrease in LDL-C was found to be associated with a smaller change in the mean IMT (p = 0.0009; Jonckheere-Terpstra trend test). A greater reduction in serum LDL-C was found to be associated with a smaller change in the mean IMT. Similar associations were observed for the serum TC and non-HDL-C levels and LDL-C/HDL-C ratio. There were no notable differences in the incidence of serious adverse events among the LDL-C quartiles. Conclusions: Lowering the LDL-C level with intensive lipid-lowering therapy is associated with reduced changes in the IMT among Japanese subjects at moderate to high risk under treatment for primary prevention. Subjects suitable for primary prevention may receive cardiovascular benefits from intensive lipid-lowering therapy, in association with significantly slower IMT progression than that observed with conventional therapy. J Atheroscler Thromb, 2014; 21:739-754.

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“…The Agatston CAC score has demonstrated utility in improving cardiovascular risk prediction in patients with an intermediate Framingham risk score (11), as well as many patient subsets not fully captured by the Framingham risk score (9, 12).…”

Section: Traditional Agatston Cac Scoring-strengths and Limitationsmentioning

confidence: 99%

Usefulness of Regional Distribution of Coronary Artery Calcium to Improve the Prediction of All-Cause Mortality

Tota-Maharaj

Joshi²,

Budoff

et al. 2015

The American Journal of Cardiology

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2010 ACCF/AHA Guideline for Assessment of Cardiovascular Risk in Asymptomatic Adults

Cited by 1,174 publications

References 457 publications

Prediction of Cardiovascular Disease by the Framingham‐REGICOR Equation in the High‐Risk PREDIMED Cohort: Impact of the Mediterranean Diet Across Different Risk Strata

Prediction of Cardiovascular Disease by the Framingham‐REGICOR Equation in the High‐Risk PREDIMED Cohort: Impact of the Mediterranean Diet Across Different Risk Strata

Can Intensive Lipid-Lowering Therapy Improve the Carotid Intima-Media Thickness in Japanese Subjects Under Primary Prevention for Cardiovascular Disease?: The JART and JART Extension Subanalysis

Usefulness of Regional Distribution of Coronary Artery Calcium to Improve the Prediction of All-Cause Mortality

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