Τίτλος:
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
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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.
Συγγραφείς:
Viswanathan, V.
Jamthikar, A.D.
Gupta, D.
Puvvula, A.
Khanna, N.N.
Saba, L.
Viskovic, K.
Mavrogeni, S.
Turk, M.
Laird, J.R.
Pareek, G.
Miner, M.
Ajuluchukwu, J.
Sfikakis, P.P.
Protogerou, A.
Kitas, G.D.
Nicolaides, A.
Sharma, A.
Suri, J.S.
Περιοδικό:
International Angiology
Εκδότης:
Edizioni Minerva Medica
Λέξεις-κλειδιά:
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
DOI:
10.23736/S0392-9590.20.04338-2
