Use of clinical scores in young Australian adults for prediction of atherosclerosis in middle age
Abstract We sought to apply a simple cardiovascular health tool not requiring laboratory tests (the Fuster-BEWAT score, FBS) to predict subclinical atherosclerosis. This study included 2657 young adults (< 40 years of age). In the prognostic group (n = 894, followed for 13 years until aged 40–50 ...
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| Format: | Article |
| Language: | English |
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BMC
2023-02-01
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| Series: | BMC Cardiovascular Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12872-023-03060-x |
| _version_ | 1828041788410036224 |
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| author | Quan Huynh Alison J. Venn Costan G. Magnussen Hong Yang Prasanna Venkataraman Terence Dwyer Thomas H. Marwick |
| author_facet | Quan Huynh Alison J. Venn Costan G. Magnussen Hong Yang Prasanna Venkataraman Terence Dwyer Thomas H. Marwick |
| author_sort | Quan Huynh |
| collection | DOAJ |
| description | Abstract We sought to apply a simple cardiovascular health tool not requiring laboratory tests (the Fuster-BEWAT score, FBS) to predict subclinical atherosclerosis. This study included 2657 young adults (< 40 years of age). In the prognostic group (n = 894, followed for 13 years until aged 40–50 years at follow-up), the primary outcome was presence of carotid plaque measured by carotid ultrasound at follow-up. Of these 894 participants, 86 (9.6%) had unilateral, and 23 participants (2.6%) had bilateral, carotid plaques at follow-up. The baseline FBS was predictive of carotid plaque at follow-up [odds ratio OR = 0.86 (95% CI 0.77–0.96) per 1-SD increase in FBS], similar to prediction from Pooled Cohort Equation [PCE, OR = 0.72 (0.61–0.85) per 1-SD decrease in PCE]. Risk scores at baseline predicted outcomes more strongly than those at follow-up, and did so independently of any changes over 13 years of follow-up. Similar discrimination for predicting carotid plaque after 13 years was found for both baseline FBS [C-statistic = 0.68 (95% CI 0.62–0.74)] and PCE [C-statistic = 0.69 (95% CI 0.63–0.75)]. Application of this FBS prognostic information to a contemporary cohort of 1763 young adults anticipates the future development of plaque in 305 (17.3%), especially in the 1494 participants (85%) with ≤ 2 metrics of ideal health. In conclusions, FBS measured in young adulthood predicted atherosclerosis 13 years later in middle age, independent of score changes over the follow-up period, emphasizing the importance of early damage to vascular health. FBS may be a simple and feasible risk score for engaging low-risk young people with reduction of future cardiovascular risk. |
| first_indexed | 2024-04-10T17:21:20Z |
| format | Article |
| id | doaj.art-2b22f59097cd4dbb977b66018a47d0bc |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-04-10T17:21:20Z |
| publishDate | 2023-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-2b22f59097cd4dbb977b66018a47d0bc2023-02-05T12:04:11ZengBMCBMC Cardiovascular Disorders1471-22612023-02-0123111010.1186/s12872-023-03060-xUse of clinical scores in young Australian adults for prediction of atherosclerosis in middle ageQuan Huynh0Alison J. Venn1Costan G. Magnussen2Hong Yang3Prasanna Venkataraman4Terence Dwyer5Thomas H. Marwick6Baker Heart and Diabetes Research InstituteMenzies Institute for Medical Research, University of TasmaniaBaker Heart and Diabetes Research InstituteMenzies Institute for Medical Research, University of TasmaniaBaker Heart and Diabetes Research InstituteMenzies Institute for Medical Research, University of TasmaniaBaker Heart and Diabetes Research InstituteAbstract We sought to apply a simple cardiovascular health tool not requiring laboratory tests (the Fuster-BEWAT score, FBS) to predict subclinical atherosclerosis. This study included 2657 young adults (< 40 years of age). In the prognostic group (n = 894, followed for 13 years until aged 40–50 years at follow-up), the primary outcome was presence of carotid plaque measured by carotid ultrasound at follow-up. Of these 894 participants, 86 (9.6%) had unilateral, and 23 participants (2.6%) had bilateral, carotid plaques at follow-up. The baseline FBS was predictive of carotid plaque at follow-up [odds ratio OR = 0.86 (95% CI 0.77–0.96) per 1-SD increase in FBS], similar to prediction from Pooled Cohort Equation [PCE, OR = 0.72 (0.61–0.85) per 1-SD decrease in PCE]. Risk scores at baseline predicted outcomes more strongly than those at follow-up, and did so independently of any changes over 13 years of follow-up. Similar discrimination for predicting carotid plaque after 13 years was found for both baseline FBS [C-statistic = 0.68 (95% CI 0.62–0.74)] and PCE [C-statistic = 0.69 (95% CI 0.63–0.75)]. Application of this FBS prognostic information to a contemporary cohort of 1763 young adults anticipates the future development of plaque in 305 (17.3%), especially in the 1494 participants (85%) with ≤ 2 metrics of ideal health. In conclusions, FBS measured in young adulthood predicted atherosclerosis 13 years later in middle age, independent of score changes over the follow-up period, emphasizing the importance of early damage to vascular health. FBS may be a simple and feasible risk score for engaging low-risk young people with reduction of future cardiovascular risk.https://doi.org/10.1186/s12872-023-03060-xAtherosclerotic riskCarotid plaqueFuster BEWAT scoreIdeal cardiovascular health scorePooled cohort equation |
| spellingShingle | Quan Huynh Alison J. Venn Costan G. Magnussen Hong Yang Prasanna Venkataraman Terence Dwyer Thomas H. Marwick Use of clinical scores in young Australian adults for prediction of atherosclerosis in middle age BMC Cardiovascular Disorders Atherosclerotic risk Carotid plaque Fuster BEWAT score Ideal cardiovascular health score Pooled cohort equation |
| title | Use of clinical scores in young Australian adults for prediction of atherosclerosis in middle age |
| title_full | Use of clinical scores in young Australian adults for prediction of atherosclerosis in middle age |
| title_fullStr | Use of clinical scores in young Australian adults for prediction of atherosclerosis in middle age |
| title_full_unstemmed | Use of clinical scores in young Australian adults for prediction of atherosclerosis in middle age |
| title_short | Use of clinical scores in young Australian adults for prediction of atherosclerosis in middle age |
| title_sort | use of clinical scores in young australian adults for prediction of atherosclerosis in middle age |
| topic | Atherosclerotic risk Carotid plaque Fuster BEWAT score Ideal cardiovascular health score Pooled cohort equation |
| url | https://doi.org/10.1186/s12872-023-03060-x |
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