The Added Value of Coronary Calcium Score in Predicting Cardiovascular Events in Familial Hypercholesterolemia
This study aimed at investigating the additional contribution of coronary artery calcium (CAC) score to SAFEHEART (Spanish Familial Hypercholesterolemia Cohort Study) risk equation (SAFEHEART-RE) for cardiovascular risk prediction in heterozygous familial hypercholesterolemia (HeFH). Common cardiova...
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| Veröffentlicht in: | JACC. Cardiovascular imaging 2021-12, Vol.14 (12), p.2414-2424 |
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| creator | Gallo, Antonio Pérez de Isla, Leopoldo Charrière, Sybil Vimont, Alexandre Alonso, Rodrigo Muñiz-Grijalvo, Ovidio Díaz-Díaz, José L. Zambón, Daniel Moulin, Philippe Bruckert, Eric Mata, Pedro Béliard, Sophie Angoulvant, Denis Beliard, Sophie Boccara, Franck Bruckert, Eric Cariou, Bertrand Carreau, Valérie Carrie, Alain Charrieres, Sybil Cottin, Yves Di Filippo, Mathilde Ducluzeau, Pierre Henri Dulong, Sonia Durlach, Vincent Farnier, Michel Ferrari, Emile Ferrieres, Dorota Ferrieres, Jean Gallo, Antonio Giral, Philippe Gonbert, Sophie Hankard, Regis Inamo, Jocelyn Kalmykova, Olga Krempf, Michel Lemale, Julie Moulin, Philippe Paillard, François Peretti, Noel Perrin, Agnes Pradignac, Alain Rabes, Jean Pierre Rigalleau, Vincent Schiele, François Sultan, Ariane Tounian, Patrick Valero, René Verges, Bruno Yelnik, Cecile Ziegler, Olivier Aguado, Rocío Alonso, Rodrigo Álvarez-Baños, Ma Pilar Argüeso, Rosa Arrieta, Francisco Barba, Miguel Ángel Casañas, Marta Cepeda, José María De Andrés, Raimundo Díaz-Soto, Gonzalo Díaz-Diaz, Jose Luis Dieguez, Marta Faedo, Ceferino Fuentes, Francisco Garrido, Juan A. González, Aurora González-Bustos, Pablo Mañas, Ma Dolores Mata, Pedro Mauri, Marta Mediavilla, Juan Diego Michán, Alfredo Miramontes, Pablo Muñiz, Ovidio Pérez, Leire De Isla, Leopoldo Perez Pintó, Xavier Romero, Manuel J. Rubio, Patricia Sánchez Muñoz-Torrero, Juan F. Vidal-Pardo, Jose I. Zambón, Daniel |
| description | This study aimed at investigating the additional contribution of coronary artery calcium (CAC) score to SAFEHEART (Spanish Familial Hypercholesterolemia Cohort Study) risk equation (SAFEHEART-RE) for cardiovascular risk prediction in heterozygous familial hypercholesterolemia (HeFH).
Common cardiovascular risk equations are imprecise for HeFH. Because of the high phenotype variability of HeFH, CAC score could help to better stratify the risk of atherosclerotic cardiovascular disease (ASCVD).
REFERCHOL (French Registry of Familial Hypercholesterolemia) and SAFEHEART are 2 ongoing national registries on HeFH. We analyzed data from primary prevention HeFH patients undergoing CAC quantification. We used probability-weighted Cox proportional hazards models to estimate HRs. Area under the receiver-operating characteristic curve (AUC) and net reclassification improvement (NRI) were used to compare the incremental contribution of CAC score when added to the SAFEHEART-RE for ASCVD prediction. ASCVD was defined as coronary heart disease, stroke or transient ischemic attack, peripheral artery disease, resuscitated sudden death, and cardiovascular death.
We included 1,624 patients (mean age: 48.5 ± 12.8 years; men: 45.7%) from both registries. After a median follow-up of 2.7 years (interquartile range: 0.4-5.0 years), ASCVD occurred in 81 subjects. The presence of a CAC score of >100 was associated with an HR of 32.05 (95% CI: 10.08-101.94) of developing ASCVD as compared to a CAC score of 0. Receiving-operating curve analysis showed a good performance of CAC score alone in ASCVD prediction (AUC: 0.860 [95% CI: 0.853-0.869]). The addition of log(CAC + 1) to SAFEHEART-RE resulted in a significantly improved prediction of ASCVD (AUC: 0.884 [95% CI: 0.871-0.894] for SAFEHEART-RE + log(CAC + 1) vs AUC: 0.793 [95% CI: 0.779-0.818] for SAFEHEART-RE; P < 0.001). These results were confirmed also when considering only hard cardiovascular endpoints. The addition of CAC score was associated with an estimated overall net reclassification improvement of 45.4%.
CAC score proved its use in improving cardiovascular risk stratification and ASCVD prediction in statin-treated HeFH.
[Display omitted] |
| doi_str_mv | 10.1016/j.jcmg.2021.06.011 |
| format | Article |
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Common cardiovascular risk equations are imprecise for HeFH. Because of the high phenotype variability of HeFH, CAC score could help to better stratify the risk of atherosclerotic cardiovascular disease (ASCVD).
REFERCHOL (French Registry of Familial Hypercholesterolemia) and SAFEHEART are 2 ongoing national registries on HeFH. We analyzed data from primary prevention HeFH patients undergoing CAC quantification. We used probability-weighted Cox proportional hazards models to estimate HRs. Area under the receiver-operating characteristic curve (AUC) and net reclassification improvement (NRI) were used to compare the incremental contribution of CAC score when added to the SAFEHEART-RE for ASCVD prediction. ASCVD was defined as coronary heart disease, stroke or transient ischemic attack, peripheral artery disease, resuscitated sudden death, and cardiovascular death.
We included 1,624 patients (mean age: 48.5 ± 12.8 years; men: 45.7%) from both registries. After a median follow-up of 2.7 years (interquartile range: 0.4-5.0 years), ASCVD occurred in 81 subjects. The presence of a CAC score of >100 was associated with an HR of 32.05 (95% CI: 10.08-101.94) of developing ASCVD as compared to a CAC score of 0. Receiving-operating curve analysis showed a good performance of CAC score alone in ASCVD prediction (AUC: 0.860 [95% CI: 0.853-0.869]). The addition of log(CAC + 1) to SAFEHEART-RE resulted in a significantly improved prediction of ASCVD (AUC: 0.884 [95% CI: 0.871-0.894] for SAFEHEART-RE + log(CAC + 1) vs AUC: 0.793 [95% CI: 0.779-0.818] for SAFEHEART-RE; P < 0.001). These results were confirmed also when considering only hard cardiovascular endpoints. The addition of CAC score was associated with an estimated overall net reclassification improvement of 45.4%.
CAC score proved its use in improving cardiovascular risk stratification and ASCVD prediction in statin-treated HeFH.
[Display omitted]</description><identifier>ISSN: 1936-878X</identifier><identifier>EISSN: 1876-7591</identifier><identifier>DOI: 10.1016/j.jcmg.2021.06.011</identifier><identifier>PMID: 34274263</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Atherosclerosis ; Calcium ; cardiovascular disease ; Cohort Studies ; coronary artery calcium ; Coronary Artery Disease - diagnostic imaging ; coronary imaging ; familial hypercholesterolemia ; genetic disease ; Humans ; Hyperlipoproteinemia Type II - diagnostic imaging ; Hyperlipoproteinemia Type II - genetics ; Life Sciences ; Male ; Middle Aged ; Predictive Value of Tests ; Risk Assessment ; Risk Factors ; risk prediction ; Vascular Calcification - diagnostic imaging</subject><ispartof>JACC. Cardiovascular imaging, 2021-12, Vol.14 (12), p.2414-2424</ispartof><rights>2021 American College of Cardiology Foundation</rights><rights>Copyright © 2021 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c434t-8b96282de0234982569b2764650b2934bfe9d5c6430bc47767a69083f10fb67a3</citedby><cites>FETCH-LOGICAL-c434t-8b96282de0234982569b2764650b2934bfe9d5c6430bc47767a69083f10fb67a3</cites><orcidid>0000-0002-9585-0571 ; 0000-0002-5176-5121 ; 0000-0002-0959-2001 ; 0000-0003-4974-6551 ; 0000-0002-1580-8040 ; 0000-0003-0788-8092 ; 0000-0001-6206-5908 ; 0000-0002-1863-1711 ; 0000-0002-7695-077X ; 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Daniel</creatorcontrib><creatorcontrib>Moulin, Philippe</creatorcontrib><creatorcontrib>Bruckert, Eric</creatorcontrib><creatorcontrib>Mata, Pedro</creatorcontrib><creatorcontrib>Béliard, Sophie</creatorcontrib><creatorcontrib>Angoulvant, Denis</creatorcontrib><creatorcontrib>Beliard, Sophie</creatorcontrib><creatorcontrib>Boccara, Franck</creatorcontrib><creatorcontrib>Bruckert, Eric</creatorcontrib><creatorcontrib>Cariou, Bertrand</creatorcontrib><creatorcontrib>Carreau, Valérie</creatorcontrib><creatorcontrib>Carrie, Alain</creatorcontrib><creatorcontrib>Charrieres, Sybil</creatorcontrib><creatorcontrib>Cottin, Yves</creatorcontrib><creatorcontrib>Di Filippo, Mathilde</creatorcontrib><creatorcontrib>Ducluzeau, Pierre Henri</creatorcontrib><creatorcontrib>Dulong, Sonia</creatorcontrib><creatorcontrib>Durlach, Vincent</creatorcontrib><creatorcontrib>Farnier, Michel</creatorcontrib><creatorcontrib>Ferrari, Emile</creatorcontrib><creatorcontrib>Ferrieres, Dorota</creatorcontrib><creatorcontrib>Ferrieres, Jean</creatorcontrib><creatorcontrib>Gallo, Antonio</creatorcontrib><creatorcontrib>Giral, Philippe</creatorcontrib><creatorcontrib>Gonbert, Sophie</creatorcontrib><creatorcontrib>Hankard, Regis</creatorcontrib><creatorcontrib>Inamo, Jocelyn</creatorcontrib><creatorcontrib>Kalmykova, Olga</creatorcontrib><creatorcontrib>Krempf, Michel</creatorcontrib><creatorcontrib>Lemale, Julie</creatorcontrib><creatorcontrib>Moulin, Philippe</creatorcontrib><creatorcontrib>Paillard, François</creatorcontrib><creatorcontrib>Peretti, Noel</creatorcontrib><creatorcontrib>Perrin, Agnes</creatorcontrib><creatorcontrib>Pradignac, Alain</creatorcontrib><creatorcontrib>Rabes, Jean Pierre</creatorcontrib><creatorcontrib>Rigalleau, Vincent</creatorcontrib><creatorcontrib>Schiele, François</creatorcontrib><creatorcontrib>Sultan, Ariane</creatorcontrib><creatorcontrib>Tounian, Patrick</creatorcontrib><creatorcontrib>Valero, 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Pablo</creatorcontrib><creatorcontrib>Mañas, Ma Dolores</creatorcontrib><creatorcontrib>Mata, Pedro</creatorcontrib><creatorcontrib>Mauri, Marta</creatorcontrib><creatorcontrib>Mediavilla, Juan Diego</creatorcontrib><creatorcontrib>Michán, Alfredo</creatorcontrib><creatorcontrib>Miramontes, Pablo</creatorcontrib><creatorcontrib>Muñiz, Ovidio</creatorcontrib><creatorcontrib>Pérez, Leire</creatorcontrib><creatorcontrib>De Isla, Leopoldo Perez</creatorcontrib><creatorcontrib>Pintó, Xavier</creatorcontrib><creatorcontrib>Romero, Manuel J.</creatorcontrib><creatorcontrib>Rubio, Patricia</creatorcontrib><creatorcontrib>Sánchez Muñoz-Torrero, Juan F.</creatorcontrib><creatorcontrib>Vidal-Pardo, Jose I.</creatorcontrib><creatorcontrib>Zambón, Daniel</creatorcontrib><creatorcontrib>REFERCHOL and SAFEHEART Investigators</creatorcontrib><title>The Added Value of Coronary Calcium Score in Predicting Cardiovascular Events in Familial Hypercholesterolemia</title><title>JACC. Cardiovascular imaging</title><addtitle>JACC Cardiovasc Imaging</addtitle><description>This study aimed at investigating the additional contribution of coronary artery calcium (CAC) score to SAFEHEART (Spanish Familial Hypercholesterolemia Cohort Study) risk equation (SAFEHEART-RE) for cardiovascular risk prediction in heterozygous familial hypercholesterolemia (HeFH).
Common cardiovascular risk equations are imprecise for HeFH. Because of the high phenotype variability of HeFH, CAC score could help to better stratify the risk of atherosclerotic cardiovascular disease (ASCVD).
REFERCHOL (French Registry of Familial Hypercholesterolemia) and SAFEHEART are 2 ongoing national registries on HeFH. We analyzed data from primary prevention HeFH patients undergoing CAC quantification. We used probability-weighted Cox proportional hazards models to estimate HRs. Area under the receiver-operating characteristic curve (AUC) and net reclassification improvement (NRI) were used to compare the incremental contribution of CAC score when added to the SAFEHEART-RE for ASCVD prediction. ASCVD was defined as coronary heart disease, stroke or transient ischemic attack, peripheral artery disease, resuscitated sudden death, and cardiovascular death.
We included 1,624 patients (mean age: 48.5 ± 12.8 years; men: 45.7%) from both registries. After a median follow-up of 2.7 years (interquartile range: 0.4-5.0 years), ASCVD occurred in 81 subjects. The presence of a CAC score of >100 was associated with an HR of 32.05 (95% CI: 10.08-101.94) of developing ASCVD as compared to a CAC score of 0. Receiving-operating curve analysis showed a good performance of CAC score alone in ASCVD prediction (AUC: 0.860 [95% CI: 0.853-0.869]). The addition of log(CAC + 1) to SAFEHEART-RE resulted in a significantly improved prediction of ASCVD (AUC: 0.884 [95% CI: 0.871-0.894] for SAFEHEART-RE + log(CAC + 1) vs AUC: 0.793 [95% CI: 0.779-0.818] for SAFEHEART-RE; P < 0.001). These results were confirmed also when considering only hard cardiovascular endpoints. The addition of CAC score was associated with an estimated overall net reclassification improvement of 45.4%.
CAC score proved its use in improving cardiovascular risk stratification and ASCVD prediction in statin-treated HeFH.
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Cardiology</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>1XC</scope><scope>VOOES</scope><orcidid>https://orcid.org/0000-0002-9585-0571</orcidid><orcidid>https://orcid.org/0000-0002-5176-5121</orcidid><orcidid>https://orcid.org/0000-0002-0959-2001</orcidid><orcidid>https://orcid.org/0000-0003-4974-6551</orcidid><orcidid>https://orcid.org/0000-0002-1580-8040</orcidid><orcidid>https://orcid.org/0000-0003-0788-8092</orcidid><orcidid>https://orcid.org/0000-0001-6206-5908</orcidid><orcidid>https://orcid.org/0000-0002-1863-1711</orcidid><orcidid>https://orcid.org/0000-0002-7695-077X</orcidid><orcidid>https://orcid.org/0000-0002-6000-5028</orcidid></search><sort><creationdate>202112</creationdate><title>The Added Value of Coronary Calcium Score in Predicting Cardiovascular Events in Familial Hypercholesterolemia</title><author>Gallo, Antonio ; Pérez de Isla, Leopoldo ; Charrière, Sybil ; Vimont, Alexandre ; Alonso, Rodrigo ; Muñiz-Grijalvo, Ovidio ; Díaz-Díaz, José L. ; Zambón, Daniel ; Moulin, Philippe ; Bruckert, Eric ; Mata, Pedro ; Béliard, Sophie ; Angoulvant, Denis ; Beliard, Sophie ; Boccara, Franck ; Bruckert, Eric ; Cariou, Bertrand ; Carreau, Valérie ; Carrie, Alain ; Charrieres, Sybil ; Cottin, Yves ; Di Filippo, Mathilde ; Ducluzeau, Pierre Henri ; Dulong, Sonia ; Durlach, Vincent ; Farnier, Michel ; Ferrari, Emile ; Ferrieres, Dorota ; Ferrieres, Jean ; Gallo, Antonio ; Giral, Philippe ; Gonbert, Sophie ; Hankard, Regis ; Inamo, Jocelyn ; Kalmykova, Olga ; Krempf, Michel ; Lemale, Julie ; Moulin, Philippe ; Paillard, François ; Peretti, Noel ; Perrin, Agnes ; Pradignac, Alain ; Rabes, Jean Pierre ; Rigalleau, Vincent ; Schiele, François ; Sultan, Ariane ; Tounian, Patrick ; Valero, René ; Verges, Bruno ; Yelnik, Cecile ; Ziegler, Olivier ; Aguado, Rocío ; Alonso, Rodrigo ; Álvarez-Baños, Ma Pilar ; Argüeso, Rosa ; Arrieta, Francisco ; Barba, Miguel Ángel ; Casañas, Marta ; Cepeda, José María ; De Andrés, Raimundo ; Díaz-Soto, Gonzalo ; Díaz-Diaz, Jose Luis ; Dieguez, Marta ; Faedo, Ceferino ; Fuentes, Francisco ; Garrido, Juan A. ; González, Aurora ; González-Bustos, Pablo ; Mañas, Ma Dolores ; Mata, Pedro ; Mauri, Marta ; Mediavilla, Juan Diego ; Michán, Alfredo ; Miramontes, Pablo ; Muñiz, Ovidio ; Pérez, Leire ; De Isla, Leopoldo Perez ; Pintó, Xavier ; Romero, Manuel J. ; Rubio, Patricia ; Sánchez Muñoz-Torrero, Juan F. ; Vidal-Pardo, Jose I. ; Zambón, Daniel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c434t-8b96282de0234982569b2764650b2934bfe9d5c6430bc47767a69083f10fb67a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Atherosclerosis</topic><topic>Calcium</topic><topic>cardiovascular disease</topic><topic>Cohort Studies</topic><topic>coronary artery calcium</topic><topic>Coronary Artery Disease - diagnostic imaging</topic><topic>coronary imaging</topic><topic>familial hypercholesterolemia</topic><topic>genetic disease</topic><topic>Humans</topic><topic>Hyperlipoproteinemia Type II - diagnostic imaging</topic><topic>Hyperlipoproteinemia Type II - genetics</topic><topic>Life Sciences</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Predictive Value of Tests</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>risk prediction</topic><topic>Vascular Calcification - diagnostic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gallo, Antonio</creatorcontrib><creatorcontrib>Pérez de Isla, Leopoldo</creatorcontrib><creatorcontrib>Charrière, Sybil</creatorcontrib><creatorcontrib>Vimont, Alexandre</creatorcontrib><creatorcontrib>Alonso, Rodrigo</creatorcontrib><creatorcontrib>Muñiz-Grijalvo, Ovidio</creatorcontrib><creatorcontrib>Díaz-Díaz, José L.</creatorcontrib><creatorcontrib>Zambón, Daniel</creatorcontrib><creatorcontrib>Moulin, Philippe</creatorcontrib><creatorcontrib>Bruckert, Eric</creatorcontrib><creatorcontrib>Mata, Pedro</creatorcontrib><creatorcontrib>Béliard, Sophie</creatorcontrib><creatorcontrib>Angoulvant, Denis</creatorcontrib><creatorcontrib>Beliard, Sophie</creatorcontrib><creatorcontrib>Boccara, Franck</creatorcontrib><creatorcontrib>Bruckert, Eric</creatorcontrib><creatorcontrib>Cariou, Bertrand</creatorcontrib><creatorcontrib>Carreau, Valérie</creatorcontrib><creatorcontrib>Carrie, Alain</creatorcontrib><creatorcontrib>Charrieres, Sybil</creatorcontrib><creatorcontrib>Cottin, Yves</creatorcontrib><creatorcontrib>Di Filippo, Mathilde</creatorcontrib><creatorcontrib>Ducluzeau, Pierre Henri</creatorcontrib><creatorcontrib>Dulong, Sonia</creatorcontrib><creatorcontrib>Durlach, Vincent</creatorcontrib><creatorcontrib>Farnier, Michel</creatorcontrib><creatorcontrib>Ferrari, Emile</creatorcontrib><creatorcontrib>Ferrieres, Dorota</creatorcontrib><creatorcontrib>Ferrieres, Jean</creatorcontrib><creatorcontrib>Gallo, Antonio</creatorcontrib><creatorcontrib>Giral, Philippe</creatorcontrib><creatorcontrib>Gonbert, Sophie</creatorcontrib><creatorcontrib>Hankard, Regis</creatorcontrib><creatorcontrib>Inamo, Jocelyn</creatorcontrib><creatorcontrib>Kalmykova, Olga</creatorcontrib><creatorcontrib>Krempf, Michel</creatorcontrib><creatorcontrib>Lemale, Julie</creatorcontrib><creatorcontrib>Moulin, Philippe</creatorcontrib><creatorcontrib>Paillard, François</creatorcontrib><creatorcontrib>Peretti, Noel</creatorcontrib><creatorcontrib>Perrin, Agnes</creatorcontrib><creatorcontrib>Pradignac, Alain</creatorcontrib><creatorcontrib>Rabes, Jean Pierre</creatorcontrib><creatorcontrib>Rigalleau, Vincent</creatorcontrib><creatorcontrib>Schiele, François</creatorcontrib><creatorcontrib>Sultan, Ariane</creatorcontrib><creatorcontrib>Tounian, Patrick</creatorcontrib><creatorcontrib>Valero, René</creatorcontrib><creatorcontrib>Verges, Bruno</creatorcontrib><creatorcontrib>Yelnik, Cecile</creatorcontrib><creatorcontrib>Ziegler, Olivier</creatorcontrib><creatorcontrib>Aguado, Rocío</creatorcontrib><creatorcontrib>Alonso, Rodrigo</creatorcontrib><creatorcontrib>Álvarez-Baños, Ma Pilar</creatorcontrib><creatorcontrib>Argüeso, Rosa</creatorcontrib><creatorcontrib>Arrieta, Francisco</creatorcontrib><creatorcontrib>Barba, Miguel Ángel</creatorcontrib><creatorcontrib>Casañas, Marta</creatorcontrib><creatorcontrib>Cepeda, José María</creatorcontrib><creatorcontrib>De Andrés, Raimundo</creatorcontrib><creatorcontrib>Díaz-Soto, Gonzalo</creatorcontrib><creatorcontrib>Díaz-Diaz, Jose Luis</creatorcontrib><creatorcontrib>Dieguez, Marta</creatorcontrib><creatorcontrib>Faedo, Ceferino</creatorcontrib><creatorcontrib>Fuentes, Francisco</creatorcontrib><creatorcontrib>Garrido, Juan A.</creatorcontrib><creatorcontrib>González, Aurora</creatorcontrib><creatorcontrib>González-Bustos, Pablo</creatorcontrib><creatorcontrib>Mañas, Ma Dolores</creatorcontrib><creatorcontrib>Mata, Pedro</creatorcontrib><creatorcontrib>Mauri, Marta</creatorcontrib><creatorcontrib>Mediavilla, Juan Diego</creatorcontrib><creatorcontrib>Michán, Alfredo</creatorcontrib><creatorcontrib>Miramontes, Pablo</creatorcontrib><creatorcontrib>Muñiz, Ovidio</creatorcontrib><creatorcontrib>Pérez, Leire</creatorcontrib><creatorcontrib>De Isla, Leopoldo Perez</creatorcontrib><creatorcontrib>Pintó, Xavier</creatorcontrib><creatorcontrib>Romero, Manuel J.</creatorcontrib><creatorcontrib>Rubio, Patricia</creatorcontrib><creatorcontrib>Sánchez Muñoz-Torrero, Juan F.</creatorcontrib><creatorcontrib>Vidal-Pardo, Jose I.</creatorcontrib><creatorcontrib>Zambón, Daniel</creatorcontrib><creatorcontrib>REFERCHOL and SAFEHEART Investigators</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><jtitle>JACC. Cardiovascular imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gallo, Antonio</au><au>Pérez de Isla, Leopoldo</au><au>Charrière, Sybil</au><au>Vimont, Alexandre</au><au>Alonso, Rodrigo</au><au>Muñiz-Grijalvo, Ovidio</au><au>Díaz-Díaz, José L.</au><au>Zambón, Daniel</au><au>Moulin, Philippe</au><au>Bruckert, Eric</au><au>Mata, Pedro</au><au>Béliard, Sophie</au><au>Angoulvant, Denis</au><au>Beliard, Sophie</au><au>Boccara, Franck</au><au>Bruckert, Eric</au><au>Cariou, Bertrand</au><au>Carreau, Valérie</au><au>Carrie, Alain</au><au>Charrieres, Sybil</au><au>Cottin, Yves</au><au>Di Filippo, Mathilde</au><au>Ducluzeau, Pierre Henri</au><au>Dulong, Sonia</au><au>Durlach, Vincent</au><au>Farnier, Michel</au><au>Ferrari, Emile</au><au>Ferrieres, Dorota</au><au>Ferrieres, Jean</au><au>Gallo, Antonio</au><au>Giral, Philippe</au><au>Gonbert, Sophie</au><au>Hankard, Regis</au><au>Inamo, Jocelyn</au><au>Kalmykova, Olga</au><au>Krempf, Michel</au><au>Lemale, Julie</au><au>Moulin, Philippe</au><au>Paillard, François</au><au>Peretti, Noel</au><au>Perrin, Agnes</au><au>Pradignac, Alain</au><au>Rabes, Jean Pierre</au><au>Rigalleau, Vincent</au><au>Schiele, François</au><au>Sultan, Ariane</au><au>Tounian, Patrick</au><au>Valero, René</au><au>Verges, Bruno</au><au>Yelnik, Cecile</au><au>Ziegler, Olivier</au><au>Aguado, Rocío</au><au>Alonso, Rodrigo</au><au>Álvarez-Baños, Ma Pilar</au><au>Argüeso, Rosa</au><au>Arrieta, Francisco</au><au>Barba, Miguel Ángel</au><au>Casañas, Marta</au><au>Cepeda, José María</au><au>De Andrés, Raimundo</au><au>Díaz-Soto, Gonzalo</au><au>Díaz-Diaz, Jose Luis</au><au>Dieguez, Marta</au><au>Faedo, Ceferino</au><au>Fuentes, Francisco</au><au>Garrido, Juan A.</au><au>González, Aurora</au><au>González-Bustos, Pablo</au><au>Mañas, Ma Dolores</au><au>Mata, Pedro</au><au>Mauri, Marta</au><au>Mediavilla, Juan Diego</au><au>Michán, Alfredo</au><au>Miramontes, Pablo</au><au>Muñiz, Ovidio</au><au>Pérez, Leire</au><au>De Isla, Leopoldo Perez</au><au>Pintó, Xavier</au><au>Romero, Manuel J.</au><au>Rubio, Patricia</au><au>Sánchez Muñoz-Torrero, Juan F.</au><au>Vidal-Pardo, Jose I.</au><au>Zambón, Daniel</au><aucorp>REFERCHOL and SAFEHEART Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Added Value of Coronary Calcium Score in Predicting Cardiovascular Events in Familial Hypercholesterolemia</atitle><jtitle>JACC. Cardiovascular imaging</jtitle><addtitle>JACC Cardiovasc Imaging</addtitle><date>2021-12</date><risdate>2021</risdate><volume>14</volume><issue>12</issue><spage>2414</spage><epage>2424</epage><pages>2414-2424</pages><issn>1936-878X</issn><eissn>1876-7591</eissn><abstract>This study aimed at investigating the additional contribution of coronary artery calcium (CAC) score to SAFEHEART (Spanish Familial Hypercholesterolemia Cohort Study) risk equation (SAFEHEART-RE) for cardiovascular risk prediction in heterozygous familial hypercholesterolemia (HeFH).
Common cardiovascular risk equations are imprecise for HeFH. Because of the high phenotype variability of HeFH, CAC score could help to better stratify the risk of atherosclerotic cardiovascular disease (ASCVD).
REFERCHOL (French Registry of Familial Hypercholesterolemia) and SAFEHEART are 2 ongoing national registries on HeFH. We analyzed data from primary prevention HeFH patients undergoing CAC quantification. We used probability-weighted Cox proportional hazards models to estimate HRs. Area under the receiver-operating characteristic curve (AUC) and net reclassification improvement (NRI) were used to compare the incremental contribution of CAC score when added to the SAFEHEART-RE for ASCVD prediction. ASCVD was defined as coronary heart disease, stroke or transient ischemic attack, peripheral artery disease, resuscitated sudden death, and cardiovascular death.
We included 1,624 patients (mean age: 48.5 ± 12.8 years; men: 45.7%) from both registries. After a median follow-up of 2.7 years (interquartile range: 0.4-5.0 years), ASCVD occurred in 81 subjects. The presence of a CAC score of >100 was associated with an HR of 32.05 (95% CI: 10.08-101.94) of developing ASCVD as compared to a CAC score of 0. Receiving-operating curve analysis showed a good performance of CAC score alone in ASCVD prediction (AUC: 0.860 [95% CI: 0.853-0.869]). The addition of log(CAC + 1) to SAFEHEART-RE resulted in a significantly improved prediction of ASCVD (AUC: 0.884 [95% CI: 0.871-0.894] for SAFEHEART-RE + log(CAC + 1) vs AUC: 0.793 [95% CI: 0.779-0.818] for SAFEHEART-RE; P < 0.001). These results were confirmed also when considering only hard cardiovascular endpoints. The addition of CAC score was associated with an estimated overall net reclassification improvement of 45.4%.
CAC score proved its use in improving cardiovascular risk stratification and ASCVD prediction in statin-treated HeFH.
[Display omitted]</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>34274263</pmid><doi>10.1016/j.jcmg.2021.06.011</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-9585-0571</orcidid><orcidid>https://orcid.org/0000-0002-5176-5121</orcidid><orcidid>https://orcid.org/0000-0002-0959-2001</orcidid><orcidid>https://orcid.org/0000-0003-4974-6551</orcidid><orcidid>https://orcid.org/0000-0002-1580-8040</orcidid><orcidid>https://orcid.org/0000-0003-0788-8092</orcidid><orcidid>https://orcid.org/0000-0001-6206-5908</orcidid><orcidid>https://orcid.org/0000-0002-1863-1711</orcidid><orcidid>https://orcid.org/0000-0002-7695-077X</orcidid><orcidid>https://orcid.org/0000-0002-6000-5028</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1936-878X |
| ispartof | JACC. Cardiovascular imaging, 2021-12, Vol.14 (12), p.2414-2424 |
| issn | 1936-878X 1876-7591 |
| language | eng |
| recordid | cdi_hal_primary_oai_HAL_hal_03328261v1 |
| source | MEDLINE; Elsevier ScienceDirect Journals; EZB-FREE-00999 freely available EZB journals |
| subjects | Adult Atherosclerosis Calcium cardiovascular disease Cohort Studies coronary artery calcium Coronary Artery Disease - diagnostic imaging coronary imaging familial hypercholesterolemia genetic disease Humans Hyperlipoproteinemia Type II - diagnostic imaging Hyperlipoproteinemia Type II - genetics Life Sciences Male Middle Aged Predictive Value of Tests Risk Assessment Risk Factors risk prediction Vascular Calcification - diagnostic imaging |
| title | The Added Value of Coronary Calcium Score in Predicting Cardiovascular Events in Familial Hypercholesterolemia |
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