@article{3121573,
    title = "Integration of estimated glomerular filtration rate biomarker in image-based cardiovascular disease/stroke risk calculator: A South Asian-Indian diabetes cohort with moderate chronic kidney disease",
    author = "Viswanathan, V. and Jamthikar, A.D. and Gupta, D. and Puvvula, A. and Khanna, N.N. and Saba, L. and Viskovic, K. and Mavrogeni, S. and Turk, M. and Laird, J.R. and Pareek, G. and Miner, M. and Ajuluchukwu, J. and Sfikakis, P.P. and Protogerou, A. and Kitas, G.D. and Nicolaides, A. and Sharma, A. and Suri, J.S.",
    journal = "International Angiology",
    year = "2020",
    volume = "39",
    number = "4",
    pages = "290-306",
    publisher = "Edizioni Minerva Medica",
    issn = "0392-9590",
    doi = "10.23736/S0392-9590.20.04338-2",
    keywords = "biological marker;  glucose;  hemoglobin A1c;  high density lipoprotein cholesterol;  low density lipoprotein cholesterol;  biological marker, adult;  age;  aged;  area under the curve;  arterial wall thickness;  Article;  atherosclerosis;  body mass;  cardiovascular disease;  cardiovascular risk;  carotid atherosclerosis;  carotid intima-media thickness;  cerebrovascular accident;  chronic kidney failure;  common carotid artery;  controlled study;  coronary artery calcification;  diabetes mellitus;  diagnostic accuracy;  dyslipidemia;  estimated glomerular filtration rate;  ethnicity;  female;  gender;  glomerulus filtration rate;  hospitalization;  human;  hypertension;  major clinical study;  male;  non insulin dependent diabetes mellitus;  peripheral occlusive artery disease;  phenotype;  QRISK score;  receiver operating characteristic;  retrospective study;  risk assessment;  risk factor;  smoking;  spondylolisthesis;  systolic blood pressure;  ultrasound;  cardiovascular disease;  cerebrovascular accident;  chronic kidney failure;  diabetes mellitus;  diagnostic imaging;  middle aged, Biomarkers;  Cardiovascular Diseases;  Carotid Intima-Media Thickness;  Diabetes Mellitus;  Female;  Glomerular Filtration Rate;  Humans;  Male;  Middle Aged;  Renal Insufficiency, Chronic;  Retrospective Studies;  Stroke",
    abstract = "Background: Recently, a 10-year image-based integrated calculator (called AtheroEdge Composite Risk Score-AECRS1.0) was developed which combines conventional cardiovascular risk factors (CCVRF) with image phenotypes derived from carotid ultrasound (CUS). Such calculators did not include chronic kidney disease (CKD)-based biomarker called estimated glomerular filtration rate (eGFR). The novelty of this study is to design and develop an advanced integrated version called-AECRS2.0 that combines eGFR with image phenotypes to compute the composite risk score. Furthermore, AECRS2.0 was benchmarked against QRISK3 which considers eGFR for risk assessment. Methods: The method consists of three major steps: 1) five, current CUS image phenotypes (CUSIP) measurements using AtheroEdge system (AtheroPoint, CA, USA) consisting of: average carotid intima-media thickness (cIMTave), maximum cIMT (cIMTmax), minimum cIMT (cIMTmin), variability in cIMT (cIMTV), and total plaque area (TPA); 2) five, 10-year CUSIP measurements by combining these current five CUSIP with 11 CCVRF (age, ethnicity, gender, body mass index, systolic blood pressure, smoking, carotid artery type, hemoglobin, low-density lipoprotein cholesterol, total cholesterol, and eGFR); 3) AECRS2.0 risk score computation and its comparison to QRISK3 using area-under-the-curve (AUC). Results: South Asian-Indian 339 patients were retrospectively analyzed by acquiring their left/right common carotid arteries (678 CUS, mean age: 54.25±9.84 years; 75.22% males; 93.51% diabetic with HbA1c ≥6.5%; and mean eGFR 73.84±20.91 mL/min/1.73m2). The proposed AECRS2.0 reported higher AUC (AUC=0.89, P<0.001) compared to QRISK3 (AUC=0.51, P<0.001) by ~74% in CKD patients. Conclusions: An integrated calculator AECRS2.0 can be used to assess the 10-year CVD/stroke risk in patients suffering from CKD. AECRS2.0 was much superior to QRISK3. © 2020 EDIZIONI MINERVA MEDICA."
}