Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Risk Score in Young Adults Predicts Coronary Artery and Abdominal Aorta Calcium in Middle Age

Abstract

Background We explored whether, the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) coronary and abdominal risk scores measured at ages 18–30 years and changes in these scores would more strongly predict coronary artery calcium (CAC) and abdominal aortic calcium (AAC) assessed 25 years later, than scores measured 25 years later. Methods and Results In the Coronary Artery Risk Development in Young Adults study, 3008 participants had measurements of risk score components at 5 year intervals beginning at ages 18–30 years. CAC and AAC were assessed at age 43–55 years. Odds ratios (OR) for presence and extent of CAC/AAC per/point higher score and c-statistics for predicting CAC/AAC were calculated. Prevalence of CAC was 28% and AAC was 53%. For each one point higher PDAY score, odds of CAC were higher using baseline scores than year 25 scores (OR 1.29 [95% CI 1.25–1.33] vs 1.12 [1.11–1.14]). For AAC, ORs at years 0 and 25 were similar (1.29 [1.24–1.34] vs 1.22 [1.19 –1.26]). C-statistic for CAC prediction was higher at year 0 than year 25 (0.731 vs 0.705) but similar at years 0 and 25 for AAC (0.665 vs 0.670). ORs for CAC were highest at baseline, and for AAC, year 10. Including change in PDAY scores with baseline scores improved prediction. Conclusions Atherosclerosis risk and change in risk assessed in young adulthood years prior to subclinical atherosclerosis imaging provide strong prediction of future subclinical atherosclerosis. CAC and AAC reflect chronic risk exposure in addition to risk measured at time of study.

Hypertriglyceridemic Waist: A Simple Marker of High‐Risk Atherosclerosis Features Associated With Excess Visceral Adiposity/Ectopic Fat

“…The integrated 10‐year Framingham Risk Score (FRS), informing on the estimated risk of cardiovascular events, has been calculated for all participants . Furthermore, we computed the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) risk score; given the wide range of age of our population, the PDAY risk score was computed from the modifiable risk factors, as previously reported …”

Dislipidemias en niños y adolescentes: factores determinantes y recomendaciones para su diagnóstico y manejo.

“…Lo descrito habla del conjunto de factores determinantes de las dislipidemias, teniendo en cuenta factores del medio ambiente, del estilo de vida, la genética y calidad de atención de los servicios de salud 18 . Así mismo, estudios de cohortes han mostrado que la presencia de dislipidemias en población pediátrica y adolescente, perdura en la edad adulta y se asocia a enfermedad cardiovascular futura [19][20][21][22][23] . En España, las comunidades de Aragón, Castilla-León, Cataluña, La Rioja, Madrid, Navarra y País Vasco ya incluyen el diagnóstico genético en sus estrategias de detección de la hipercolesterolemia familiar.…”

Adolescence and depression: reducing cardiovascular disease through preventive health checks

“…There is a strong association between the PDAY risk score measured in young adulthood and the presence and severity of coronary atherosclerosis in middle age (Gidding et al, 2016).…”

“…Many studies have shown that risk factors measured in adolescents and early adulthood predict atherosclerosis in adults aged 30 to 45 years (Gidding et al,20 16). The physiological risk factors for atherosclerosis in middle age were measured using pathobiological determinants of atherosclerosis in youth (PDAY) scores, which measures age, gender, non-HDL cholesterol, HDL cholesterol, smoking, blood pressure, obesity and hyperglycemia (Gidding et al, 2016). As each risk factor is added, a one-point increase in the score is also added.…”

“…As each risk factor is added, a one-point increase in the score is also added. An increase in the total score is associated with the odds ratio for an increase in atherosclerosis that would occur with one year of aging (Gidding et al, 2016).…”