000			03658nam a22006257a 4500
008			240807s20242024 xxu||||| |||| 00| 0 eng d
022			_a2047-9980
040			_aOvid MEDLINE(R)
099			_a38979824
245			_aAddition of Social Determinants of Health to Coronary Heart Disease Risk Prediction: The Multi-Ethnic Study of Atherosclerosis.
251			_aJournal of the American Heart Association. 13(14):e033651, 2024 Jul 16.
252			_aJ Am Heart Assoc. 13(14):e033651, 2024 Jul 16.
253			_aJournal of the American Heart Association
260			_c2024
260			_fFY2025
260			_p2024 Jul 16
265			_sppublish
265			_tMEDLINE
266			_d2024-08-07
266			_z2024/07/09 07:24
520			_aBACKGROUND: Social determinants of health (SDoH) are associated with cardiovascular risk factors and outcomes; however, they are absent from risk prediction models. We aimed to assess if the addition of SDoH improves the predictive ability of the MESA (Multi-Ethnic Study of Atherosclerosis) Risk Score.
520			_aCONCLUSIONS: Significant associations were found between economic/financial SDoH and CHD risk factors and outcomes. Incorporation of SDoH into the MESA Risk Score did not improve predictive ability of the model. Our findings do not support the incorporation of SDoH into current risk prediction algorithms.
520			_aMETHODS AND RESULTS: This was a community-based prospective population cohort study that enrolled 6286 men and women, ages 45-84 years, who were free of clinical coronary heart disease (CHD) at baseline. Data from 10-year follow-up were examined for CHD events, defined as myocardial infarction, fatal CHD, resuscitated cardiac arrest, and revascularization in cases of anginal symptoms. Participants included 53% women with average age of 62 years. When adjusting for traditional cardiovascular risk factors, SDoH, and coronary artery calcium, economic strain, specifically low family income, was associated with a greater risk of CHD events (hazard ratio [HR], 1.42 [95% CI, 1.17-1.71], P value<0.001). Area under the curve of risk prediction with SDoH was 0.822, compared with 0.816 without SDoH. The calibration slope was 0.860 with SDoH and 0.878 in the original model.
546			_aEnglish
650			_a*Coronary Disease
650			_a*Social Determinants of Health
650			_aAged
650			_aAged, 80 and over
650			_aCoronary Disease/di [Diagnosis]
650			_aCoronary Disease/eh [Ethnology]
650			_aCoronary Disease/ep [Epidemiology]
650			_aEthnicity/sn [Statistics & Numerical Data]
650			_aFemale
650			_aHeart Disease Risk Factors
650			_aHumans
650			_aMale
650			_aMiddle Aged
650			_aPredictive Value of Tests
650			_aPrognosis
650			_aProspective Studies
650			_aRisk Assessment
650			_aRisk Factors
650			_aSocial Determinants of Health/eh [Ethnology]
650			_aUnited States/ep [Epidemiology]
650			_zAutomated
651			_aMedStar Union Memorial Hospital
656			_aInternal Medicine Residency
657			_aJournal Article
657			_aMulticenter Study
700			_aAcquah, Isaac _bMUMH _cInternal Medicine Residency _dMBChB
790			_aMurphy BS, Nam Y, McClelland RL, Acquah I, Cainzos-Achirica M, Nasir K, Post WS, Aldrich MC, DeFilippis AP
856			_uhttps://dx.doi.org/10.1161/JAHA.123.033651 _zhttps://dx.doi.org/10.1161/JAHA.123.033651
858			_yAcquah, Isaac _uhttps://orcid.org/0000-0003-2554-7806 _zhttps://orcid.org/0000-0003-2554-7806
942			_cART _dArticle
999			_c14537 _d14537