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Performance of traditional risk factors in identifying a higher than expected coronary atherosclerotic burden

2015-04-01Artigo científico Acesso aberto
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dc.contributor.authorDores, Hélder
dc.contributor.authorDores, Helder
dc.contributor.authorDe Araújo Gonçalves, Pedro
dc.contributor.authorFerreira, António Miguel
dc.contributor.authorCarvalho, Maria Salomé
dc.contributor.authorSousa, Pedro Jerónimo
dc.contributor.authorCardim, Nuno
dc.contributor.authorCardim, Nuno
dc.contributor.authorMarques, Hugo
dc.contributor.authorPinto Marques, Hugo
dc.contributor.authorPereira Machado, Francisco
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.pblSociedade Portuguesa de Cardiologia | Elsevier
dc.date.accessioned2023-02-15T22:17:19Z
dc.date.available2023-02-15T22:17:19Z
dc.date.issued2015-04-01
dc.description.abstractAbstract Objective To evaluate the performance of traditional cardiovascular (CV) risk factors in identifying a higher than expected coronary atherosclerotic burden. Methods We assessed 2069 patients undergoing coronary CT angiography, with assessment of calcium score (CS), for suspected coronary artery disease. A higher than expected atherosclerotic burden was defined as CS >75th percentile (CS >P75) according to age and gender-adjusted monograms. The ability of traditional CV risk factors to predict a CS >P75 was assessed in a customized logistic regression model ("Clinical Score") and by the calculation of SCORE (Systemic Coronary Risk Evaluation). The population attributable risk (PAR) of risk factors for CS >P75 was calculated. Results The median CS was 3.0 (IQR 0.0-98.0); 362 patients had CS >P75. The median SCORE was 3.0 (IQR 1.0-4.0). With the exception of hypertension, all traditional CV risk factors were independent predictors of CS >P75: diabetes, dyslipidemia, smoking and family history (OR 1.3-2.2, p≤0.026). The areas under the ROC curves for CS >P75 were 0.64 for the Clinical Score (95% CI 0.61-0.67, p<0.001) and 0.53 for SCORE (95% CI 0.50-0.56, p=0.088). About a quarter of patients with CS >P75 were in the two lower quartiles of the Clinical Score. Altogether, the traditional risk factors explain 56% of the prevalence of CS >P75 (adjusted PAR 0.56). Conclusion Despite the association of CV risk factors with a higher than expected atherosclerotic burden, they appear to explain only half of its prevalence. Even when integrated in scores, the predictive power of these risk factors was modest, exposing the limitations of risk stratification based solely on demographic and clinical risk factors.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent7
dc.format.extent679638
dc.identifier.doi10.1016/j.repc.2014.08.030
dc.identifier.issn0870-2551
dc.identifier.otherPURE: 17663359
dc.identifier.otherPURE UUID: faf09e20-773a-41e0-be23-a5e59525371d
dc.identifier.otherScopus: 84928207800
dc.identifier.otherPubMed: 25843312
dc.identifier.otherWOS: 000356401100004
dc.identifier.otherORCID: /0000-0003-3540-0488/work/128879031
dc.identifier.urihttp://hdl.handle.net/10362/149270
dc.identifier.urlhttps://www.scopus.com/pages/publications/84928207800
dc.language.isoeng
dc.peerreviewedyes
dc.subjectAtherosclerotic burden
dc.subjectAttributable risk
dc.subjectCalcium score
dc.subjectCT angiography
dc.subjectRisk factor
dc.subjectCardiology and Cardiovascular Medicine
dc.subjectSDG 3 - Good Health and Well-being
dc.titlePerformance of traditional risk factors in identifying a higher than expected coronary atherosclerotic burdenen
dc.typejournal article
degois.publication.firstPage247
degois.publication.issue4
degois.publication.lastPage253
degois.publication.titleRevista Portuguesa de Cardiologia
degois.publication.volume34
dspace.entity.typePublication
person.familyNameDores
person.familyNameCardim
person.familyNamePinto Marques
person.givenNameHelder
person.givenNameNuno
person.givenNameHugo
person.identifier.ciencia-id0317-133B-8C14
person.identifier.orcid0000-0002-4736-5221
person.identifier.orcid0000-0002-3812-4872
person.identifier.orcid0000-0003-3540-0488
person.identifier.scopus-author-id24537571800
rcaap.rightsopenAccess
relation.isAuthorOfPublication20b0e882-d27f-4be5-8151-ec0d0a9b7185
relation.isAuthorOfPublicationbcbf3f33-253a-4b76-a55f-23e4caf28001
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relation.isAuthorOfPublication.latestForDiscoverybcbf3f33-253a-4b76-a55f-23e4caf28001

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