Framingham Risk Score Score Research Articles

Risk factors and assessment of subclinical atherosclerosis in patients with psoriatic arthritis

ObjectiveTo understand the prevalence of subclinical atherosclerosis (SCA) in psoriatic arthritis (PsA) patients; to explore the correlation between PsA combined with SCA and traditional cardiovascular risk factors and disease activity; to compare the role of Framingham Risk Score (FRS) and atherosclerotic cardiovascular disease (ASCVD) scores. MethodsWe included 50 PsA patients who met the CASPAR classification criteria, 50 diabetes patients and 50 healthy people. Clinical data were collected from all patients, minimal disease activity (MDA), disease activity index for psoriatic arthritis (DAPSA), ASCVD, FRS were assessed in patients with PsA, and carotid artery intima–media thickness was measured. ResultsThe prevalence of SCA in PsA patients was significantly higher than that in healthy controls (44% vs 24%, P<0.05). Smoking, drinking, ASCVD, FRS were the risk factors of PsA with SCA (P<0.05). Psoriasis (PsO) duration, PtGA, VAS and DAPSA were the risk factors for PsA with SCA (P<0.05). FRS and ASCVD scores underestimated SCA risk in PsA patients. ConclusionCompared with healthy controls, patients with PsA have higher prevalence of SCA. High DAPSA is a risk factor for PsA with SCA. Carotid ultrasound can monitor SCA in patients with PsA, improve stratification of cardiovascular risk.

Associations between the Framingham Risk Score and cognitive functions in people with multiple sclerosis

Background &amp; Objective: Cognitive impairment is common in people with multiple sclerosis (MS). The Framingham Risk Score (FRS) is an algorithm used to estimate the 10-year risk of developing cardiovascular disease (CVDr). This study aimed to evaluate the possible associations between FRS and cognitive impairment in people with MS. Methods: Demographic characteristics, laboratory parameters, clinical findings, vascular risk factors, and Brief International Cognitive Assessment for MS (BICAMS) test results, FRS and CVDr scores were recorded for 110 MS patients. Results: FRS and CVDr scores exhibited a significant negative correlation with the number of correct responses in the Symbol Digit Modalities Test (p &lt; 0.001 for all) and California Verbal Learning Test–Second UK Edition (CVLT-II) test (p &lt; 0.001 for all), and significant positive correlation with the number of incorrect responses in the CVLT-II (p &lt; 0.001 for all). The total score of the Brief Visuospatial Memory Test Revised had a negative correlation with FRS and CVDr (p &lt; 0.001 for both). BICAMS scores showed no significant correlation with smoking status, homocysteine, and uric acid levels. Conclusion: We suppose that vascular risk factors and FRS and CVDr scores may be associated with the deterioration of working memory, information processing speed, verbal learning, and memory in people with MS. Based on the potential impact of vascular risk factors on cognitive functions, our findings suggest that lifestyle changes, appropriate treatment, and using a multidisciplinary approach toward vascular risk factors during MS management may exhibit a positive effect on cognition in people with MS.

An exploratory analysis of the metabolic syndrome and cardiovascular disease risk calculations in veterans with spinal cord injury and disorders

Objectives (1) To describe and compare cardiovascular and cardiometabolic disease risk scores using three existing risk calculators: Framingham Risk Score (FRS), American Heart Association (AHA) and Metabolic Syndrome Severity Score (MSSS) in Veterans with spinal cord injury and disorders (SCI/D); (2) To examine level of agreement between risk scores derived from three different risk scoring systems; and (3) To investigate whether the agreement among these methods is different for Veterans with Tetraplegia versus Paraplegia. Design Retrospective chart review. Methods Electronic medical records of 194 Veterans with SCI/D who were seen at the VAPAHCS SCI/D Center between August 2004 and June 2022 were reviewed. Cardiovascular disease (CVD) risk scores (FRS and AHA) along with a Metabolic Syndrome Severity Score (MSSS) were computed using web-based calculators. Results Moderate agreement between CVD risk scores (FRS and AHA) was observed; however, the agreement was poor between MSSS and both AHA and FRS. No differences were observed between the paraplegia and tetraplegia cohorts. From the AHA risk score, more than half the study population was found to be at high risk while less than half was considered high risk from the FRS and MSSS scores. Conclusions Given the moderate association between AHA and FRS scores along with considerable variation in risk predictors, CVD risk prediction assessment tools should be interpreted cautiously in the SCI population. SCI-related clinical biomarkers and other clinically relevant risk factors should be taken into consideration to optimize risk estimation in persons with SCI/D.

A study to assess the effect of yoga and diet on Framingham risk score among high-risk cardiovascular subjects.

Cardiovascular diseases (CVDs) are a cluster of disorders of blood vessels and the heart. As a form of physical activity, yoga postures, and pranayama have been shown to be beneficial in various health conditions, i.e. hypertension, prediabetes, and diabetes among high-risk subjects. This study aimed to evaluate the impact of yoga and diet on the Framingham risk score (FRS) among high-risk cardiovascular subjects. The experimental interventional study was conducted at "RUHS College of Medical Sciences" and Associated Group of Hospitals", Jaipur among high-risk cardiovascular subjects. FRS was used as a measurement for the outcome of interest at baseline and six months of yoga diet intervention in the study and control groups. Mean age of participants was 48.43 ± 6.4 years. Baseline values (mean ± SD) of FRS 24.59 ± 10.15 after six months of yogic lifestyle 15.1 ± 7.05. After six months of yogic lifestyle FRS scores and estimated 10-year cardiovascular risk were statistically significantly (P < 0.0001) decreased. Pearson correlation analysis results depict that FRS correlation. There was a strong positive correlation between the FRS score and total cholesterol (r = 0.787; P < 0.001) and a negative strong correlation between the FRS score and high-density lipoprotein was observed (r =-0.621; P < 0.002). The findings of this study conclude that six months of yoga and diet lifestyle intervention significantly decreased FRS among high-risk CVD subjects compared to the control group.

Predictability of Cardiovascular Risk Scores for Carotid Atherosclerosis in Community-Dwelling Middle-Aged and Elderly Adults.

Background: The assessment of future risk of cardiovascular diseases (CVD) is strongly recommended for all asymptomatic adults without CVD history. Carotid atherosclerosis (CA) is a preclinical phenotype of CVDs. However, data on estimated future CVD risks with respect to preclinical atherosclerosis are limited. This community-based study aimed to assess the relationships between predicted CVD risks and CA. Methods: We enrolled 3908 subjects aged 40-74 years without CVD history and calculated their 10-year CVD risks using the Framingham Risk Score (FRS) and the Pooled Cohort Equations (PCE). Carotid plaque (CP) at the extracranial carotid arteries was determined by high-resolution B-mode ultrasonography and further classified into mild or advanced CA. Results: The means of FRS for CP-negative and mild and advanced CA were 9.0%, 14.4%, and 22.1%, respectively (p-value < 0.0001). The corresponding values for PCE score were 4.8%, 8.8%, and 15.0%, respectively (p-value < 0.0001). The odds ratios (ORs) of having CP per 5.0% increase in FRS and PCE score were 1.23 (95% CI, 1.19-1.28) and 1.36 (95% CI, 1.28-1.44), respectively. The corresponding values of having advanced CA were 1.24 (95% CI, 1.19-1.29) and 1.38 (95% CI, 1.30-1.48), respectively. Among the models of FRS or PCE plus other conventional CVD risk factors, the FRS + age model had the highest discrimination for the presence of CP (AUROC, 0.7533; 95% CI, 0.7375-0.7691) as well as for the presence of advanced CA (AUROC, 0.8034; 95% CI, 0.7835-0.8232). The calibration of the FRS + age models for the presences of CP and advanced CA was excellent (χ2 = 8.45 [p = 0.49] and 10.49 [p = 0.31], respectively). Conclusions: Estimated future CVD risks were significantly correlated with risks of having CA. Both FRS and PCE had good discrimination for the presences of CP and advanced CA.

Liposomal-Associated Phospholipase A 2 Is More Effective in Predicting Cardiac Risk in Law Enforcement Than Framingham Risk Score and Coronary Artery Calcium Score Calculation.

To clarify the methods for identifying officers at high risk for cardiac events. This retrospective review included 3330 patient charts. Classic cardiovascular risk factors, coronary artery calcium (CAC) scores, and endothelial inflammatory biomarker levels were compared between civilians and law enforcement officers (LEOs). The Framingham Risk Score (FRS) was compared with risk assessment using inflammatory biomarkers. The FRS failed to identify more than 90% of LEOs at high risk of cardiovascular events. Similarly, the use of the CAC score was ineffective. Inflammatory biomarker analysis measuring the lipoprotein-associated phospholipase A 2 activity was the most reliable method for identifying LEOs at high risk of cardiovascular events. The use of the standard FRS and CAC scores is less effective than that of inflammatory biomarkers in identifying LEOs at high risk of cardiovascular events.

Recalibration of Framingham Risk Score for predicting 10-year cardiovascular disease risk in a South Indian population

Abstract Background: Cardiovascular diseases (CVDs) are the leading cause of mortality in India. Guidelines recommend using tools, such as the Framingham Risk Score (FRS), to predict the 10-year CVD risk of adults for primary prevention of CVDs. However, FRS was developed based on data from a predominantly White population in the United States, limiting its applicability to other regions. Objectives: This study aimed to recalibrate the FRS equations among adults in Kerala, India. Materials and Methods: Baseline survey data from the Kerala Diabetes Prevention Program were analyzed: 921 males and 567 females for lipid-based FRS scores and 1042 males and 646 females for body mass index (BMI)-based FRS scores. Recalibration of the original FRS scores was performed using local data on CVD risk factors and CVD mortality. Results: Among males, the median 10-year CVD risk with the recalibrated lipid-based FRS score was 7.34 (interquartile ranges [IQR] 4.33–12.42), compared with the original score of 8.88 (5.23–14.87) (P &lt; 0.001). For BMI-based FRS scores, the median 10-year CVD risk was 7.40 (4.27–11.83) for the recalibrated score, compared with 9.32 (5.40–14.80) for the original score (P &lt; 0.001). In females, the median 10-year CVD risk was 4.83 (2.90–8.36) for the recalibrated score, compared with 2.85 (IQR 1.71–4.98) for the original score (P &lt; 0.001). Similarly, the median 10-year CVD risk was 4.66 (2.74–8.81) for the recalibrated BMI-based FRS score, compared for 2.95 (1.72–5.61) with the original score (P &lt; 0.001). Conclusion: Recalibrated FRS scores estimated a significantly lower 10-year CVD risk in males and a higher risk in females than the original FRS scores.

Older PLHIV are at Higher Cardiovascular Risk with Poor Quality of Life.

People with HIV (PLHIV) face increased cardiovascular disease (CVD) risk due to inflammation and immune activation. Aging further amplifies this risk. Limited data exist on CVD risk in older PLHIV in India despite 2.14 million PLHIV with higher CVD risk factors. In a cross-sectional study in Bihar, India, 73 PLHIV and 30 control participants were enrolled. Demographics, social factors, clinical information, and CVD risk factors were collected. HbA1c levels and lipid profiles were analyzed, and 10-year CVD risk scores were calculated using the Framingham risk score (FRS) and Qrisk3. Quality of life (QoL) was assessed using WHOQOL- HIV-BREF. Results showed higher LDL levels in non-HIV older participants and higher HDL levels in younger PLHIV participants. BMI differed significantly, with higher BMI in non-HIV older individuals and lower BMI in younger PLHIV individuals. Older PLHIV participants had significantly higher mean FRS and Q-Risk scores compared to older non-PLHIV and younger PLHIV groups. Among older PLHIV participants, six had higher CVD risk per FRS, while none in the other groups were classified as high CVD risk. Psychological, social relations and spirituality domains were highly deteriorated in older PLHIV, scoring 44.48, 42.72, and 41.2, respectively. The physical domain scored 57.6, and the environment scored 52.72 in the WHOQOL-HIV bref. In conclusion, older PLHIV in Bihar, India, face higher CVD risk compared to younger PLHIV and non-HIV individuals. FRS and Q-Risk scores effectively assessed CVD risk, identifying higher risk in older PLHIV. Age and BMI were significant predictors of high CVD risk. These findings emphasize CVD risk assessment and tailored management for older PLHIV. The QoL assessment findings indicate moderate deterioration in psychological, social relations, and spirituality domains among older PLHIV individuals. These results suggest greater challenges in psychological well-being, social interactions, and spirituality compared to the overall sample. Further research with larger samples and longitudinal designs is needed to confirm and extend these findings.

Prognostic value of plaque volume combined with CT fractional flow reserve in patients with suspected coronary artery disease

To investigate the prognostic value of quantitative plaque volume on coronary computed tomography (CT) angiography (CTA) combined with CT fractional flow reserve (CT-FFR) for major adverse cardiac events (MACE) in suspected coronary artery disease (CAD) patients. Patients who underwent coronary CTA with clinically suspected CAD were enrolled retrospectively in this study. Patients' baseline, Framingham Risk Score (FRS), coronary CTA plaque assessment, and CT-FFR were analysed retrospectively. Study outcomes included rehospitalisation and MACE (ST-segment elevation myocardial infarction, unstable angina, or non-ST-segment elevation myocardial infarction, revascularisation, and cardiac death). There were 251 patients in the study, with a follow-up period of 1-6.58 years. Mean age was 61.16±10.45 years and 146 (58%) patients were male. Higher CT-adapted Leaman score and quantitative plaque volume were found in patients with FRS >0.2 regardless of categorical or continuous variables. Coronary scores, quantitative plaque parameters, and CT-FFR were associated with MACE and rehospitalisation in univariate analysis. In model 1, CT-FFR was associated with MACE in multivariate Cox analysis when adjusted for FRS and CT-adapted Leaman score. Quantitative plaque parameters including calcified plaque volume, fibro-fatty plaque volume, low-attenuation plaque volume, non-calcified plaque volume, and total plaque volume were significantly associated with MACE and improved overall prognostic performance in a model adjusted for CT-FFR. Additional quantitative plaque volume and CT-FFR further improve the predictive incremental value based on risk factor scores for prognostic prediction in patients. Adding quantitative plaque volume combined with CT-FFR analysis to anatomical and clinical assessment will be further beneficial to predict patients' prognosis of MACE.

Risk Assessment for Cardiovascular Disease Using the Framingham Risk Score and Globorisk Score Among Newly Diagnosed Metabolic Syndrome Patients.

The presence of metabolic syndrome (MetS) is linked to an increased risk of cardiovascular disease (CVD) development. In this study, CVD risk was calculated among individuals with newly diagnosed MetS using the Framingham Risk Score (FRS) and Globorisk Score. The FRS and Globorisk score are particularly relevant in predicting CVD risk as these scores include key MetS-related risk factors like blood pressure, cholesterol levels, and age. A community-based cross-sectional study was conducted at various sites in Karachi, Pakistan, from February 2022 to August 2022. Newly diagnosed cases of MetS with no physical disability, known illness, and not taking any regular medication were recruited. MetS was defined based on the definition of International Diabetes Federation. The major outcome was 10-year risk for CVD using the FRS and Globorisk Score. Of 304 patients, 59.2% were classified as low risk according to FRS, while 20.4% were classified as moderate and high risk each. Using the Globorisk score, 44.6% of 224 patients were classified as low risk, 34.4% as moderate risk, and 21.0% as high risk. A moderate positive correlation was observed between the two CVD risk scores (r = 0.651, 95% CI 0.58-0.71). Both risk scores have reported age, gender, and current smokers as significant risk factors in predicting CVD in 10-years (P < 0.05). The outcome of both CVD risk scores predicted moderate-to-high risk of CVD in 10-years in almost half of the newly diagnosed patients with MetS. In particular, the risk of development of CVD in 10-years in newly diagnosed MetS is higher with increasing age, in male gender, and current smokers.

Relative contributions of arterial stiffness to cardiovascular disease risk score in Chinese women in framingham and China-PAR model.

Arterial stiffness played an important role in the development of cardiovascular disease (CVD) events. The aim of this study was to verify the relative importance of arterial stiffness for different CVD risk scores in a large sample of Chinese women. We measured arterial velocity pulse index (AVI) and CVD risk scores in 2220 female participants (mean age 57 years). Framingham Risk Score (FRS), and the prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) were used to estimate CVD risk, respectively. The relationships between AVI and risk scores were investigated by linear regressions and restricted cubic spline (RCS) analysis. To determine the relative importance of AVI in predicting CVD risk scores, random forest analysis was used. There was a significant positive correlation between AVI and FRS, China-PAR in all subgroup groups stratified by age, blood pressure and BMI. AVI showed higher importance in predicting CVD risk scores in FRS model, compared with these traditional risk factors. In China-PAR model, although AVI was not as predictive as SBP, it had better predictive power than many known risk factors such as lipids. Furthermore, AVI had significant J-shaped associations both with FRS and China-PAR scores. AVI was significantly associated with CVD risk score. In FRS and China-PAR model, AVI showed relatively high importance in predicting CVD risk scores. These findings may support the use of arterial stiffness measurements in CVD risk assessment.

#4666 ASSOCIATION BETWEEN URINARY ALBUMIN CREATININE RATIO AND CARDIOVASCULAR DISEASE

Abstract Background and Aims The association between microalbuminuria and cardiovascular disease (CVD) is accumulating in various patient populations. However, when stratified by sex, the relationship between microalbuminuria and CVD remains unclear. Method We obtained data from the 2011–2014 and 2019–2020 Korea National Health and Nutrition Examination Survey (KNHANES). Microalbuminuria was measured based on spot urine albumin-creatinine ratio (UACR). The Framingham risk score (FRS) model was implemented to evaluate the CVD risk. Linear and logistic regression models were used to identify the associations of microalbuminuria status with cardiometabolic predictors and CVD status determined by the FRS score. Results Among 19,340 representative Korean participants, the (UACR) in Korean women and men with history of CVD was higher than in those without history of CVD. Among patients without history of CVD, multivariate regression analysis showed that a high UACR was related to older age, lower high-density lipoprotein cholesterol level, higher total cholesterol level, higher systolic blood pressure, higher prevalence of current smoking, higher prevalence of diabetes, and higher anti-hypertensive medication use in both women and men. The UACR showed a positive linear correlation with the Framingham risk score in both women and men. Conclusion The presence of microalbuminuria was significantly associated with the cardiometabolic risk factors and the increased risk of CVD evaluated by FRS model in both women and men in a nationally representative sample of Korea.

Association of cardiovascular health and risk prediction algorithms with subclinical atherosclerosis identified by carotid ultrasound

The requirement for laboratory tests to assess conventional cardiovascular disease (CVD) risk may be a barrier to the early detection and management of atherosclerosis in some population groups. A simpler risk assessment could facilitate detection of CVD. The association of the Fuster-BEWAT Score (FBS), Framingham Risk Score (FRS), and Pooled Cohort Equation (PCE) with the presence of carotid plaque was investigated, with the intention of developing a stepped screening process for the primary prevention of CVD. Asymptomatic participants with a family history of premature CVD had an absolute cardiovascular disease risk (ACVDR) score calculated using the FBS, FRS, and PCE risk equations. This risk classification was compared with the presence or absence of carotid plaque on ultrasound. Prediction of carotid plaque presence by risk scores and risk factors was assessed by logistic regression and area under the curve (AUC) for discrimination and diagnostic performance. A classification and regression-tree (CART) model was obtained for stratification of risk assessment. Risk score calculation and ultrasound scanning were performed in 1031 participants, of whom 51 had carotid plaques. Participants with plaque and male sex showed higher risk (higher PCE and FRS and lower FBS, as higher scores of FBS indicate better cardiovascular health). Participants ≤50 years of age showed the FBS was a significant predictor; there was a reduced likelihood of plaque presence with a higher score (OR 0.54, 95% CI 0.39-0.75, P < .01). Higher ACVDR (evidenced by higher PCE and FRS scores and lower FBS score) was associated with an increased likelihood of carotid plaque; however, the FBS and the addition of risk factors not included in the equation showed the highest AUC (AUC = 0.76, P < .001). CART modeling showed that participants with FBS between 6 and 9 would be recommended for further risk stratification using the PCE, whereupon a PCE score ≥5% conferred an increased risk and greater possibility for plaque. Validation of the model using a different cohort showed similar risk stratification for plaque presence according to level of risk by CART analysis. FBS was able to identify the presence of carotid plaque in asymptomatic individuals. Its use for initial risk delineation might improve the selection of patients for more specific and complex assessment, reducing cost and time.

Association between urinary albumin creatinine ratio and cardiovascular disease.

The association between microalbuminuria and cardiovascular disease (CVD) is accumulating in various patient populations. However, when stratified by sex, the relationship between microalbuminuria and CVD remains unclear. We obtained data from the 2011-2014 and 2019-2020 Korea National Health and Nutrition Examination Survey (KNHANES). Microalbuminuria was measured based on spot urine albumin-creatinine ratio (UACR). The Framingham risk score (FRS) model was implemented to evaluate the CVD risk. Linear and logistic regression models were used to identify the associations of microalbuminuria status with cardiometabolic predictors and CVD status determined by the FRS score. Among 19,340 representative Korean participants, the (UACR) in Korean women and men with history of CVD was higher than in those without history of CVD. Among patients without history of CVD, multivariate regression analysis showed that a high UACR was related to older age, lower high-density lipoprotein cholesterol level, higher total cholesterol level, higher systolic blood pressure, higher prevalence of current smoking, higher prevalence of diabetes, and higher anti-hypertensive medication use in both women and men. The UACR showed a positive linear correlation with the Framingham risk score in both women and men. The presence of microalbuminuria was significantly associated with the cardiometabolic risk factors and the increased risk of CVD evaluated by FRS model in both women and men in a nationally representative sample of Korea.

Vascular comorbidity is associated with decreased cognitive functioning in inflammatory bowel disease

Reports of cognitive impairment in inflammatory bowel disease (IBD) have been mixed. IBD and cardiovascular disease are often co-morbid, yet it remains unknown whether vascular comorbidity confers a risk for decreased cognitive functioning, as observed in other populations. Participants with IBD were recruited from a longitudinal study of immune-mediated disease. Participants were administered a standardized neuropsychological test protocol, evaluating information processing speed, verbal learning and memory, visual learning and memory, and verbal fluency/executive function. Cognitive test scores were standardized using local regression-based norms, adjusting for age, sex, and education. Vascular risk was calculated using a modified Framingham Risk Score (FRS). We tested the association between FRS and cognitive test scores using a quantile regression model, adjusting for IBD type. Of 84 IBD participants, 54 had ulcerative colitis and 30 had Crohn’s disease; mean (SD) age was 53.36 (13.95) years, and a high proportion were females (n = 58). As the risk score (FRS) increased, participants demonstrated lower performance in information processing speed (β = − 0.12; 95% CI − 0.24, − 0.006) and verbal learning (β = − 0.14; 95% CI − 0.28, − 0.01) at the 50th percentile. After adjusting for IBD type and disease activity, higher FRS remained associated with lower information processing speed (β = − 0.14; 95% CI − 0.27, − 0.065). Vascular comorbidity is associated with lower cognitive functioning in persons with IBD, particularly in the area of information processing speed. These findings suggest that prevention, identification, and treatment of vascular comorbidity in IBD may play a critical role for improving functional outcomes in IBD.

Cardiovascular risk in young healthcare workers: results from a cross-sectional study

Abstract Background Cardiovascular diseases represent the main cause of mortality worldwide. While cardiovascular risk (CVR) has decreased in grown adults and elderly in the last years due to innovative therapies and prevention, it seems to be rising among young adults. The aim of our study was to map the 10-year CVR in healthcare workers (HCWs) at the teaching hospital Policlinico Umberto I of Rome and identify possible determinants in order to design and implement preventive strategies. Methods A cross-sectional study was carried out between January 2019 and July 2020. 525 HCWs aged 20-40 years were recruited. All participants underwent, after informed consent, medical history collection, physical examination and blood tests. CVR was measured using Framingham Risk Score (FRS) and CUORE score (CVR score developed by the Italian National Institute of Health). Univariate, bivariate and multivariate analysis were performed. Results CVR evaluated with FRS correlated positively with age (β = 0.104, p &amp;lt; 0.001), being a shift worker (β = 0.06, p = 0.037), and negatively with female gender (β= -0.757, p &amp;lt; 0.001). No differences were found between being a doctor or a nurse. CVR evaluated with CUORE score correlated positively with age (β = 0.698, p &amp;lt; 0.001), and negatively with female gender (β= -0.332, p &amp;lt; 0.001) and being a doctor (β= -0.220, p &amp;lt; 0.001). Inferential analysis showed low correlation between FRS and CUORE Score (R2=0.340). Conclusions Our study demonstrates that females have a lower CVR among HCWs. On the contrary, 15% of male HCWs show a CVR above the average. FRS and CUORE score indicate that advancing age determines an increase in CVR. There is a low correlation between the scores used, in fact CUORE score underestimates the CVR of shift workers while it is known that this particular category is at higher risk. Key messages

RISK ANALYSIS AND CLASSIFICATION OF MYOCARDIAL INFARCTION FROM CAROTID INTIMA MEDIA THICKNESS OF B-MODE ULTRASOUND IMAGE USING VARIOUS MACHINE LEARNING AND DEEP LEARNING TECHNIQUES

Myocardial infarction (MI) is a life threatening condition that causes death in developing nations due to blockage in the blood vessel of the coronary artery that supplies blood to the heart. Any blockage in blood vessel of carotid artery located in the neck region can predict the risk of heart failure. Carotid Intima-Media Thickness (CIMT) measured from carotid artery supports in the estimation of heart failure. In this study, cardiovascular risk is considered based on the CIMT thickness of carotid artery blood vessels. In this paper, CIMT and Framingham risk score (FRS) boundary have been determined for both normal and cardiovascular disease (CVD) subjects, which aids in the prediction of heart failure. For 55 subjects with normal condition and 55 subjects with CVD disease, CIMT values were measured by utilizing an effective ultrasound examination system. Biochemical parameters were also measured for all the 110 subjects to predict the FRS score. Student t-test and Spearmans correlation performed showed significant results with p-value less than 0.01 for CIMT, biochemical parameters and FRS score. Receiver operating characteristic (ROC) has been plotted for measured CIMT value and FRS value indicates with an accuracy of 71%. The performance was also determined by comparing various classification techniques using machine learning and deep learning. Results observed through machine learning show that random forest, multilayer perceptron and K-nearest neighbor classifiers used in classification techniques give more superior accuracy of 79% and sensitivity of 78%. To improvise the investigation, deep learning technique using carotid artery ultrasound image of 1909 dataset has been used. Deep learning CNN architecture using VGG19 implemented gave an accuracy of 98% with sensitivity 98% and specificity 99%. It was also observed from the 20% data used for validation that 199 subjects are without risk of MI and 178 subjects were predicted with a risk of MI in future. Further relative risk analysis performed with FRS and CIMT showed that a person with low risk of FRS has 26% chances of getting abnormal CIMT and MI risk in future.

Potential of four definitions of metabolic syndrome to discriminate individuals with different 10-year cardiovascular disease risk scores: a cross-sectional analysis of an Iranian cohort

ObjectiveWe aimed to reveal the potential of four different metabolic syndrome (Mets) definitions to differentiate subjects according to 10-year risk of cardiovascular disease.DesignA cross-sectional analysis of a prospective cohort.SettingThis study...

Abstract 9982: World Health Organization Cardiovascular Risk Score Correlates with Carotid Intima-Media Thickness, but Fails to Identify High Risk Black Patients Unlike the Framingham and Atherosclerotic Cardiovascular Risk Score Models

Introduction: Correlation between various cardiovascular risk models and carotid intima-media thickness (CIMT) in the black population is not well described. To risk stratify patients in Ethiopia, three scores are used: Non-laboratory World Health Organization (nWHO) score, used for Sub-Saharan countries, ACC/AHA atherosclerotic cardiovascular risk score (ASCVD), and Framingham risk score (FRS). We compared these three scores and determined their relationship with a marker of subclinical atherosclerosis such as CIMT. Methodology: 336 patients (ages 40-79) with no atherosclerotic cardiovascular disease were randomly selected in Ethiopia’s largest tertiary hospital and underwent CIMT measurement read by blinded readers. Participants were stratified into low, intermediate, and high-risk groups based on the three scores. Pearson correlations and Freedman’s comparisons were used. Results: The three risk scores and mean CIMT were moderately correlated (Figure 1). There were strong positive correlations between ASCVD and FRS (n=284, r=0.71, CI: 0.65-0.77, p&lt;.0001), ASCVD and nWHO (n=279, r =0.73, CI: 0.67-0.78, p&lt;.0001), as well as FRS and nWHO risk scores (n=331, r=0.76, CI: 0.71-0.78, p&lt;.0001). However, there was significant disagreement in their risk categorization (Figure 2). Conclusion: Non-laboratory WHO risk score fails to identify high-risk patients stratified by ASCVD or FRS despite having similar correlations with CIMT. The use of nWHO score may underestimate risk in the Ethiopian population, compared to ASCVD and FRS scores. These findings have therapeutic implications for primary prevention.

Value of 2 risk prediction models in predicting the risk of atherosclerosis in patients with chronic kidney disease.

Cardiovascular disease (CVD) remains a high morbidity in patients with chronic kidney disease (CKD), and atherosclerosis (AS) is the main pathological basis of CVD. Atherosclerotic cardiovascular disease (ASCVD) is one of the major complications and causes of death in CKD patients. Monitoring and paying attention to the risk of AS is the manifestation of multidisciplinary comprehensive treatment. Through continuous monitoring the risk factors of AS, patients with high AS risk can be detected early, and then risk factors can be treated to improve the prognosis and life quality of CKD patients and reduce the CVD mortality of CKD. The Framingham risk prediction model and Chinese 10-year ASCVD risk prediction model can comprehensively evaluate the AS risk. The predictive value of the 2 risk prediction models has been widely confirmed in the general population, but the application in CKD population needs to be further explored. Thus, the aim of this study is to analyze the value of the 2 risk prediction models in predicting AS risk of CKD population and to find a simple and reliable method to predict AS risk of CKD population. This study was a cross-sectional study and 146 CKD patients (CKD group) and 14 healthy controls (control group) were recruited. Carotid ultrasound examination was performed to measure the intima-media thickness of left and right carotid arteries to evaluate the prevalence of AS. Medical history, physical examination, and clinical laboratory test data were collected to calculate Framingham Risk Score (FRS) and ASCVD score for all participants. We compared baseline data and AS positive rate between the CKD group and the control group. The AS positive rates detected by FRS, ASCVD score, and carotid ultrasound examination were compared in terms of Kappa consistency test, authenticity, reliability, and benefits. There were no significant differences in sex, age, and BMI between the CKD group and the control group (all P>0.05). The levels of systolic blood pressure, diastolic blood pressure, pulse pressure, total cholesterol, triglyceride, low density lipoprotein cholesterol, blood urea nitrogen, serum creatinine, and glycosylated hemoglobin in the CKD group were significantly higher than those in the control group (all P<0.05), while high density lipoprotein cholesterol and glomerular filtration rate were significantly lower than those in the control group (both P<0.05). The positive rates of AS in the CKD group detected by FRS, ASCVD score, and carotid ultrasound examination (43.84%, 53.42%, and 46.58%, respectively) were all significant higher than those in the control group (all P<0.01). There was no significant difference in the positive rate of AS in the CKD group among the 3 methods (P=0.24). The AS positive rate detected by FRS was highly consistent with ASCVD score (Kappa value was 0.647, P<0.001), FRS was moderately consistent with carotid ultrasound examination (Kappa value was 0.447, P<0.001), and ASCVD score was consistent with carotid ultrasound examination (Kappa value was 0.373, P<0.001). The sensitivities of FRS and ASCVD score were 67.65% and 73.53%, respectively, the specificities were 76.92% and 64.10%, respectively. The sensitivity was 91.44% and specificity was 49.31% when FRS and ASCVD score were used in parallel. And the sensitivity was 49.74% and the specificity was 91.71% when FRS and ASCVD score were used in series. The positive rates of AS in CKD patients detected by risk prediction models are not different from that detected by carotid artery ultrasound, and there are good consistency and coincidence rate among risk prediction models and carotid artery ultrasound. Risk prediction models are suitable for predicting the risk of AS in patients with CKD, and the combined application of them can further improve the sensitivity or specificity of diagnosis.