| 000 | 03487nam a22003497a 4500 | ||
|---|---|---|---|
| 008 | 181108s20182018 xxu||||| |||| 00| 0 eng d | ||
| 022 | _a0009-7322 | ||
| 024 | _a10.1161/CIRCULATIONAHA.118.033505 [doi] | ||
| 040 | _aOvid MEDLINE(R) | ||
| 099 | _a30354651 | ||
| 245 | _aAstronaut Cardiovascular Health and Risk Modification (Astro-CHARM) Coronary Calcium Atherosclerotic Cardiovascular Disease Risk Calculator. | ||
| 251 | _aCirculation. 138(17):1819-1827, 2018 Oct 23. | ||
| 252 | _aCirculation. 138(17):1819-1827, 2018 Oct 23. | ||
| 253 | _aCirculation | ||
| 260 | _c2018 | ||
| 260 | _fFY2019 | ||
| 265 | _sppublish | ||
| 266 | _d2018-11-09 | ||
| 501 | _aAvailable online from MWHC library: 1950 - present, Available in print through MWHC library: 1999 - 2006 | ||
| 520 | _aBACKGROUND: Coronary artery calcium (CAC) is a powerful novel risk indicator for atherosclerotic cardiovascular disease (ASCVD). Currently, there is no available ASCVD risk prediction tool that integrates traditional risk factors and CAC. | ||
| 520 | _aCONCLUSION: The Astro-CHARM tool is the first integrated ASCVD risk calculator to incorporate risk factors, including high-sensitivity C-reactive protein and family history, and CAC data. It improves risk prediction in comparison with traditional risk factor equations and could be useful in risk-based decision making for cardiovascular disease prevention in the middle-aged general population. | ||
| 520 | _aMETHODS: To develop a CAC ASCVD risk tool for younger individuals in the general population, subjects aged 40 to 65 without prior cardiovascular disease from 3 population-based cohorts were included. Cox proportional hazards models were developed incorporating age, sex, systolic blood pressure, total and high-density lipoprotein cholesterol, smoking, diabetes mellitus, hypertension treatment, family history of myocardial infarction, high-sensitivity C-reactive protein, and CAC scores (Astro-CHARM model [Astronaut Cardiovascular Health and Risk Modification]) as dependent variables and ASCVD (nonfatal/fatal myocardial infarction or stroke) as the outcome. Model performance was assessed internally, and validated externally in a fourth cohort. | ||
| 520 | _aRESULTS: The derivation study comprised 7382 individuals with a mean age 51 years, 45% women, and 55% nonwhite. The median CAC was 0 (25th, 75th [0,9]), and 304 ASCVD events occurred in a median 10.9 years of follow-up. The c-statistic was 0.784 for the risk factor model, and 0.817 for Astro-CHARM ( P<0.0001). In comparison with the risk factor model, the Astro-CHARM model resulted in integrated discrimination improvement (0.0252), and net reclassification improvement (0.121; P<0.0001), as well. The Astro-CHARM model demonstrated good discrimination (c=0.78) and calibration (Nam-D'Agostino chi<sup>2</sup>, 13.2; P=0.16) in the validation cohort (n=2057; 55 events). A mobile application and web-based tool were developed to facilitate clinical application of this tool ( www.AstroCHARM.org ). | ||
| 546 | _aEnglish | ||
| 650 | _aIN PROCESS -- NOT YET INDEXED | ||
| 651 | _aMedStar Heart & Vascular Institute | ||
| 657 | _aJournal Article | ||
| 700 | _aTaylor, Allen J | ||
| 790 | _aAyers CA, Budoff MJ, de Lemos JA, Khera A, Levine BD, Locke J, Massaro JM, McClelland RL, O'Donnell CJ, Taylor A | ||
| 856 |
_uhttps://dx.doi.org/10.1161/CIRCULATIONAHA.118.033505 _zhttps://dx.doi.org/10.1161/CIRCULATIONAHA.118.033505 |
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| 942 |
_cART _dArticle |
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| 999 |
_c3897 _d3897 |
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