Cardiovascular Risk Classes Research Articles

To What Extent Does Cardiovascular Risk Classification of Patients with Type 2 Diabetes Differ between European Guidelines from 2023, 2021, and 2019? A Cross-Sectional Study.

Background and Objectives: Type 2 Diabetes (T2DM) is intricately associated with an increased cardiovascular (CV) risk, highlighting the imperative for tailored intervention in the prevention and management of CV diseases. To assess the CV risk and subsequent interventions in patients with diabetes, the European Society of Cardiology (ESC) has been consistently developing and updating specific guidelines for risk assessment and patient management since 2019. The 2023 risk classification method has significantly changed, introducing a novel probability-based assessment through the implementation of SCORE2-Diabetes instrument. This marks a shift from the risk factor-based classification employed in the 2019 and 2021 methods, representing an innovative approach in risk assessment for individuals with T2DM. This study aims to evaluate the differences in the CV risk classification among hospitalized patients with T2DM using the three proposed methods within the Romanian population, a European population considered to be at very high cardiovascular risk. Materials and Methods: in a consecutive-case, population-based study design, 70 patients hospitalized with T2DM from a European population characterized by very high CV risk were assessed for CV risk using the three proposed methods. The differences between these classifications were subsequently analyzed. Results: In the study group, according to 2023 classification, one patient (1.4%) was classified with moderate CV risk, eight (11.4%) with high cardiovascular risk, and sixty-one (87.2%) with very high cardiovascular risk. A total of 36 patients (51.4%) were classified differently compared to 2021 criteria, the differences being statistically significant (p = 0.047), while 13 (18.6%) were different compared to 2019 criteria, the differences being statistically non-significant (p = 0.731). By comparing the 2021 to the 2019 ESC Guidelines recommendations, 40 patients had a one-step decrease in cardiovascular risk category, from very high to high risk. Conclusions: Most patients included in the analysis were classified as very high CV risk (87.2%). Within a European population characterized by very high CV risk, the SCORE2-Diabetes instrument proves to be a valuable tool, contributing to most step-ups in CV risk classes within the 2023 classification. In a very-high-risk demographic, the 2023 algorithm resulted in different classifications in contrast to the 2021 method but similar classifications observed with the 2019 method.

The impact of legs fat mass and legs lean fat mass on thigh circumference according cardiovascular risk: a population-based study

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Medical University of Bialystok, Poland Introduction A low thigh circumference is associated with an increased risk of high blood pressure, diabetes, cardiovascular diseases, and total mortality. Objectives The aim of the study was to investigate the relationship between the thigh circumference and cardiovascular (CV) risk classes, and to assess what type of tissue, adipose tissue or muscle tissue affects the thigh circumference. Methods The longitudinal, population-based, Polish study was conducted in 2017-2020. A total of 931 individuals aged 20-79 were analyzed. Pol-SCORE system was used to assess the 10-year risk of fatal CV based on the following risk factors: age, gender, smoking, systolic blood pressure, and total cholesterol for individuals aged 40-70. Then, CV risk classes were assessed using the 2019 ESC/EAS guidelines. The measurement of thigh circumference were performed directly below the gluteal fold of the thigh. Both thighs were measured and the mean value was calculated as the final thigh circumference. Body composition was assessed using Dual Energy X-ray Absorptiometry (DEXA). Results The mean age was 49.1 ± 15.5 years and 43.2% male. The mean thigh circumference was 58.2 ± 5.9 cm, the mean legs fat mass was 7.7 ± 2.8kg, and the mean legs lean mass was 16.9 ± 4.0kg. Lower thigh circumference was associated with higher CV risk classes in univariate linear regression analysis (β -0.516, p = 0.002), as well adjusted by age and sex (β -0.839, p = 0.008), adjusted by age, sex, BMI (β -0.886, p <0.001), and age, sex, WHR (β -0.988, p <0.001). In linear regression analysis legs adipose tissue and muscle tissue were related to the thigh circumference independently of CV risk classes (Model 1) and Pol-SCORE value (Model 2). However, fatty tissue (Model 1: β 0.746, p < 0.001; Model 2: β 0.749, p < 0.001) affects the thigh circumference more than the muscle tissue (Model 1: β 0.479, p < 0.001; Model 2: β 0.442, p < 0.001) (Fig. 1). Conclusion Smaller thigh circumference was associated with higher CV risk classes. Thigh circumference was more influenced by adipose tissue than by muscle tissue, regardless of the Pol-SCORE or CV risk classes. Table 1. Variable Model 1 Model 2 Beta p R2 Beta p R2 Legs fat mass 0.746 <0.001 0.785 0.749 <0.001 0.760 Legs lean mass 0.479 <0.001 0.785 0.442 <0.001 0.760 Model 1: adjusted for Cardiovascular risk classesModel 2: adjusted for Pol-SCOREResults of the linear regression analysis thigh circumference in the general population Abstract Figure 1.

On the HUNT for cardiovascular risk factors and disease in patients with psoriatic arthritis: population-based data from the Nord-Trøndelag Health Study

ObjectiveTo compare the presence of cardiovascular (CV) risk factors and established CV disease in patients with psoriatic arthritis (PsA) and the general population and to compare the 10-year risk of...

Serum Uric Acid and Cardiovascular Risk Among Portuguese Adolescents

PurposeThe aim of the study was to investigate the association between serum uric acid (SUA) and cardiovascular risk classes (CRCs) in adolescents using a cluster-based approach. MethodsA cross-sectional evaluation was carried out in the 2007–2008 school year, including adolescents born in 1990 and enrolled in the schools of Porto, Portugal. The analysis included 1,286 adolescents. To identify CRC, a normal mixture model was performed including several biological cardiovascular risk factors. A multinomial logistic regression model was applied to explore the association between SUA and each CRC. ResultsThree classes were extracted using model-based cluster analysis (low, medium, and high CRC). The high CRC accounted for the smallest proportion of participants (5.6%) and represented the adolescents with higher waist circumference, systolic and diastolic blood pressures, total cholesterol, triglycerides, and insulin levels. Adolescents at increased risk of cardiovascular disease had significantly higher mean concentrations of SUA compared with adolescents at low cardiovascular risk (55.0 vs. 51.5 mg/L in males and 41.9 vs. 37.6 mg/L in females). After adjustment and considering low CRC as reference, SUA was positively associated with high CRC in both sexes (odds ratio, 1.04; 95% confidence interval, 1.00–1.07 in males; and odds ratio, 1.04; 95% confidence interval, 1.01–1.07 in females). ConclusionsAmong 17-year-old adolescents, SUA increases were positively associated with higher CRC.

SAT0381 On the Hunt for Cardiovascular Risk Factors and Disease in Patients with Psoriatic Arthritis – Results from the Norwegian Hunt Study

BackgroundControversies exist regarding increased risk of cardiovascular (CV) disease in patients with psoriatic arthritis (PsA).ObjectivesTo compare the presence of CV risk factors and disease in patients with PsA and the...

Cardiovascular risk assessment in hypertensive patients: major discrepancy according to ESH and SCORE strategies

The European Society of Hypertension (ESH) guidelines recommend two possible strategies for the assessment of cardiovascular risk (CVR) in essential hypertensive (HT) patients: categorical tables and SCORE risk charts. However, the outcome of these methods has not been compared. We assessed CVR according to ESH and SCORE risk charts adapted to use in Belgium in 106 HT patients (mean age: 52.4 +/- 12.9 years, male/female ratio: 46/60) without diabetes or other associated clinical conditions. The distribution of low, moderate, high and very high added risk was strikingly different (kappa coefficient = 0.08) according to ESH categorical tables (n = 1, 24, 24, 57) and SCORE risk charts (n = 60, 12, 10, 24). Furthermore, compared with ESH, CVR class according to SCORE was lower in the majority of patients (n = 72, 68%) while it was similar in 23 (22%) and higher in 11 patients (10%). Patients for whom risk was lower by SCORE compared to ESH differed from the others by age (46.7 +/- 10.0 versus 64.6 +/- 9.2, P < 10) and proportion of females (71 versus 26%, P < 10). In this series of patients with mainly moderate or severe hypertension, the distribution of cardiovascular risk was strikingly different according to ESH categorical tables and SCORE risk charts. This might be explained in part by the lower weight attributed to blood pressure in risk assessment, especially in young female subjects. If confirmed, these results should prompt the performance of a prospective study to assess which strategy most accurately predicts CVR in hypertensive patients.