alexa Coronary artery calcium score combined with Framingham score for risk prediction in asymptomatic individuals.
Cardiology

Cardiology

Journal of Clinical & Experimental Cardiology

Author(s): Greenland P, LaBree L, Azen SP, Doherty TM, Detrano RC

Abstract Share this page

Abstract CONTEXT: Guidelines advise that all adults undergo coronary heart disease (CHD) risk assessment to guide preventive treatment intensity. Although the Framingham Risk Score (FRS) is often recommended for this, it has been suggested that risk assessment may be improved by additional tests such as coronary artery calcium scoring (CACS). OBJECTIVES: To determine whether CACS assessment combined with FRS in asymptomatic adults provides prognostic information superior to either method alone and whether the combined approach can more accurately guide primary preventive strategies in patients with CHD risk factors. DESIGN, SETTING, AND PARTICIPANTS: Prospective observational population-based study, of 1461 asymptomatic adults with coronary risk factors. Participants with at least 1 coronary risk factor (>45 years) underwent computed tomography (CT) examination, were screened between 1990-1992, were contacted yearly for up to 8.5 years after CT scan, and were assessed for CHD. This analysis included 1312 participants with CACS results; excluded were 269 participants with diabetes and 14 participants with either missing data or had a coronary event before CACS was performed. MAIN OUTCOME MEASURE: Nonfatal myocardial infarction (MI) or CHD death. RESULTS: During a median of 7.0 years of follow-up, 84 patients experienced MI or CHD death; 70 patients died of any cause. There were 291 (28\%) participants with an FRS of more than 20\% and 221 (21\%) with a CACS of more than 300. Compared with an FRS of less than 10\%, an FRS of more than 20\% predicted the risk of MI or CHD death (hazard ratio [HR], 14.3; 95\% confidence interval [CI]; 2.0-104; P =.009). Compared with a CACS of zero, a CACS of more than 300 was predictive (HR, 3.9; 95\% CI, 2.1-7.3; P<.001). Across categories of FRS, CACS was predictive of risk among patients with an FRS higher than 10\% (P<.001) but not with an FRS less than 10\%. CONCLUSION: These data support the hypothesis that high CACS can modify predicted risk obtained from FRS alone, especially among patients in the intermediate-risk category in whom clinical decision making is most uncertain. This article was published in JAMA and referenced in Journal of Clinical & Experimental Cardiology

Relevant Expert PPTs

Relevant Speaker PPTs

  • Donald silverberg
    Is correction of iron deficiency a new addition to the treatment of heart failure?
    PPT Version | PDF Version
  • Ahmed Zeidan
    Effects of intravenous iron in chronic kidney disease and heart failure
    PPT Version | PDF Version
  • Mapitsi S Thantsha
    In vitro antagonistic effects of Listeria adhesion protein (LAP)-expressing Lactobacillus casei against Listeria monocytogenes and Salmonella Typhimurium Copenhagen
    PPT Version | PDF Version
  • Saroj Velamakanni
    Multiparameter analysis using cell cycle biomarkers for breast cancer: Prognostic and predictive implications
    PPT Version | PDF Version
  • Mikael Bjerg Caspersen
    Innovative albumin based technology for half-life extension and optimization of Biotherapeutics
    PPT Version | PDF Version
  • Suzi Demirbag
    Indications and effectiveness of the open surgery in vesicoureteral refl ux
    PPT Version | PDF Version
  • Yosef Yarden
    Classically, the 3’untranslated region (3’UTR) is that region in eukaryotic protein-coding genes from the translation termination codon to the polyA signal. It is transcribed as an integral part of the mRNA encoded by the gene. However, there exists another kind of RNA, which consists of the 3’UTR alone, without all other elements in mRNA such as 5’UTR and coding region. The importance of independent 3’UTR RNA (referred as I3’UTR) was prompted by results of artificially introducing such RNA species into malignant mammalian cells. Since 1991, we found that the middle part of the 3’UTR of the human nuclear factor for interleukin-6 (NF-IL6) or C/EBP gene exerted tumor suppression effect in vivo. Our subsequent studies showed that transfection of C/EBP 3’UTR led to down-regulation of several genes favorable for malignancy and to up-regulation of some genes favorable for phenotypic reversion. Also, it was shown that the sequences near the termini of the C/EBP 3’UTR were important for its tumor suppression activity. Then, the C/EBP 3’UTR was found to directly inhibit the phosphorylation activity of protein kinase CPKC in SMMC-7721, a hepatocarcinoma cell line. Recently, an AU-rich region in the C/EBP 3’UTR was found also to be responsible for its tumor suppression. Recently we have also found evidence that the independent C/EBP 3’UTR RNA is actually exists in human tissues, such as fetal liver and heart, pregnant uterus, senescent fibroblasts etc. Through 1990’s to 2000’s, world scientists found several 3’UTR RNAs that functioned as artificial independent RNAs in cancer cells and resulted in tumor suppression. Interestingly, majority of genes for these RNAs have promoter-like structures in their 3’UTR regions, although the existence of their transcribed products as independent 3’UTR RNAs is still to be confirmed. Our studies indicate that the independent 3’UTR RNA is a novel non-coding RNA species whose function should be the regulation not of the expression of their original mRNA, but of some essential life activities of the cell as a whole.
    PPT Version | PDF Version
  • Alina Borowska
    Postoperative cognitive dysfunctions after cardiac operations
    PPT Version | PDF Version
  • Sergey Suchkov
    Translational tools as applicable to autoimmune disorders: antibody-proteases as a generation of highly informative and unique biomarkers to monitor subclinical and clinical stages of demyelination in multiple sclerosis (MS)
    PPT Version | PDF Version
  • Ana Domingo Rueda
    Collaborative programme in Pediatric Cardiac Surgery in Ethiopia: Nursery role
    PPT Version | PDF Version
  • Wenru Wang
    Effects of home-based cardiac rehabilitation programme for patients with acute myocardial infarction: A randomized controlled trail
    PPT Version | PDF Version
  • Cicek Senture
    Analyzing The Efficiencies Of Discharge Education For The Patients Who Had A Cardiac Surgery
    PPT Version | PDF Version
  • Lei Huo
    Diagnostic biomarkers in metastatic breast cancer
    PPT Version | PDF Version
  • Amila Orucevic
    Prognostic value of ER, PR, and HER2 breast cancer biomarkers and AJCC’s TNM staging system on overall survival of Caucasian females with breast cancer: An institution’s 10 year experience
    PPT Version | PDF Version
  • Placide Poba-Nzaou
    Open Source as an Alternative for Clinical Information Systems Adoption
    PPT Version | PDF Version

Recommended Conferences

Relevant Topics

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords