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dc.contributor.author
Perez, Hernan A.
dc.contributor.author
Garcia, Nestor Horacio
dc.contributor.author
Spence, John David
dc.contributor.author
Armando, Luis J.
dc.date.available
2018-08-30T17:04:51Z
dc.date.issued
2016-03
dc.identifier.citation
Perez, Hernan A.; Garcia, Nestor Horacio; Spence, John David; Armando, Luis J.; Adding carotid total plaque area to the Framingham risk score improves cardiovascular risk classification; Termedia Publishing House Ltd; Archives Of Medical Science; 12; 3; 3-2016; 513-520
dc.identifier.issn
1734-1922
dc.identifier.uri
http://hdl.handle.net/11336/57718
dc.description.abstract
Cardiovascular events (CE) due to atherosclerosis are preventable. Identification of high-risk patients helps to focus resources on those most likely to benefit from expensive therapy. Atherosclerosis is not considered for patient risk categorization, even though a fraction of CE are predicted by Framingham risk factors. Our objective was to assess the incremental value of combining total plaque area (TPA) with the Framingham risk score (FramSc) using post-test probability (Ptp) in order to categorize risk in patients without CE and identify those at high risk and requiring intensive treatment. Material and methods: A descriptive cross-sectional study was performed in the primary care setting in an Argentine population aged 22-90 years without CE. Both FramSc based on body mass index and Ptp-TPA were employed in 2035 patients for risk stratification and the resulting reclassification was compared. Total plaque area was measured with a high-resolution duplex ultrasound scanner. Results: 57% male, 35% hypertensive, 27% hypercholesterolemia, 14% diabetes. 20.1% were low, 28.5% moderate, and 51.5% high risk. When patients were reclassified, 36% of them changed status; 24.1% migrated to a higher and 13.6% to a lower risk level (k index = 0.360, SE k = 0.16, p < 0.05, FramSc vs. Ptp-TPA). With this reclassification, 19.3% were low, 18.9% moderate and 61.8% high risk. Conclusions: Quantification of Ptp-TPA leads to higher risk estimation than FramSc, suggesting that Ptp-TPA may be more sensitive than FramSc as a screening tool. If our observation is confirmed with a prospective study, this reclassification would improve the long-term benefits related to CE prevention.
dc.format
application/pdf
dc.language.iso
eng
dc.publisher
Termedia Publishing House Ltd
dc.rights
info:eu-repo/semantics/openAccess
dc.rights.uri
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.subject
Atherosclerosis
dc.subject
Cardiovascular Event
dc.subject
Hypertension
dc.subject.classification
Medicina Critica y de Emergencia
dc.subject.classification
Medicina Clínica
dc.subject.classification
CIENCIAS MÉDICAS Y DE LA SALUD
dc.title
Adding carotid total plaque area to the Framingham risk score improves cardiovascular risk classification
dc.type
info:eu-repo/semantics/article
dc.type
info:ar-repo/semantics/artículo
dc.type
info:eu-repo/semantics/publishedVersion
dc.date.updated
2018-08-29T18:37:58Z
dc.identifier.eissn
1896-9151
dc.journal.volume
12
dc.journal.number
3
dc.journal.pagination
513-520
dc.journal.pais
Polonia
dc.journal.ciudad
Poznań
dc.description.fil
Fil: Perez, Hernan A.. Blossom DMO; Argentina
dc.description.fil
Fil: Garcia, Nestor Horacio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba. Instituto de Investigaciones en Ciencias de la Salud; Argentina
dc.description.fil
Fil: Spence, John David. Western University. Robarts Research Institute. Stroke Prevention and Atherosclerosis Research Centre; Canadá
dc.description.fil
Fil: Armando, Luis J.. Blossom DMO; Argentina
dc.journal.title
Archives Of Medical Science
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/doi/http://dx.doi.org/10.5114/aoms.2016.59924
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