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The Role of Atherosclerotic Cardiovascular Risk Enhancers in the Prediction of Cardiovascular Events: Tehran Lipid and Glucose Study
Farzad Hadaegh
Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8935-2744
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This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Journal of Translational Medicine.
Background: To assess the effect of the atherosclerotic cardiovascular disease risk enhancing factors (ASCVD-REFs) on incident cardiovascular disease (CVD) events among non-diabetic individuals with borderline and intermediate ACC/AHA score during 10 and 15-year follow-up. Moreover, the added value of these ASCVD-REFs on the predictive power of the pooled cohort equations (PCE) was examined.
Methods: A total of 1204 adults aged 40-75 years, free from CVD at baseline with low-density lipoprotein cholesterol (LDL-C) between 70-189 mg/dl, were included. Unadjusted Cox regression analysis was used. The predictive ability of each significant ASCVD-REFs was estimated using the cut-point-free integrated discrimination improvement (IDI).
Results: During 10-year follow up, 181 CVD events (including 73 hard CVD) occurred. For hard CVD events, the high blood pressure (BP) component (i.e. ≥130/85 mmHg) of metabolic syndrome (Mets) (Hazard ratio: HR (95% CI; 1.67(1.03-2.70)) and positive history of preeclampsia (5.06(1.17-22.0)) were significant ASCVD-REFs. During the longer follow-up, Mets and its components of high waist circumference (WC) and high BP significantly increased the risk. As for CVD events, the Mets and its high BP and high WC components significantly increased the risk. However, in the ACC/AHA adjusted score, these covariates did not significantly improve the predictive power of the CVD or hard CVD.
Conclusions: The high BP was the most consistent and independent ASCVD-REFs in the prediction of all CVD and hard CVD, among the population with borderline/intermediate risk. Hence, considering pharmacologic therapies for patients with high BP and high LDL-C might be beneficial for preventive initiatives.
Keywords
Atherosclerotic cardiovascular disease, Risk enhancing factors, ACC/AHA
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CURRENT STATUS: Published
Version (no preprint)
Posted 04 Dec, 2020
Editorial decision: Minor revision
On 04 Dec, 2020
Review #3 received
Received 01 Dec, 2020
Reviewer #4 agreed
On 30 Nov, 2020
Reviewer #3 agreed
On 30 Nov, 2020
Review #1 received
Received 28 Nov, 2020
Review #2 received
Received 28 Nov, 2020
Reviewer #2 agreed
On 26 Nov, 2020
Editor assigned
On 26 Nov, 2020
Reviewers invited
Invitations sent on 26 Nov, 2020
Reviewer #1 agreed
On 26 Nov, 2020
Submission checks complete
On 26 Nov, 2020
Editor invited
On 26 Nov, 2020
This version was not preprinted
Version 1
Posted 28 Sep, 2020
Published
On 06 Jan, 2021
No community comments so far
Editorial decision: Major revision
On 17 Oct, 2020
Review #3 received
Received 13 Oct, 2020
Review #5 received
Received 11 Oct, 2020
Review #1 received
Received 03 Oct, 2020
Reviewers invited
Invitations sent on 02 Oct, 2020
Reviewer #1 agreed
On 02 Oct, 2020
Reviewer #2 agreed
On 02 Oct, 2020
Reviewer #3 agreed
On 02 Oct, 2020
Reviewer #4 agreed
On 02 Oct, 2020
Reviewer #5 agreed
On 02 Oct, 2020
Reviewer #6 agreed
On 02 Oct, 2020
Reviewer #7 agreed
On 02 Oct, 2020
Reviewer #8 agreed
On 02 Oct, 2020
Reviewer #9 agreed
On 02 Oct, 2020
Reviewer #10 agreed
On 02 Oct, 2020
Review #2 received
Received 02 Oct, 2020
Review #4 received
Received 02 Oct, 2020
Editor assigned
On 30 Sep, 2020
Editor invited
On 29 Sep, 2020
Submission checks complete
On 24 Sep, 2020
First submitted
On 19 Sep, 2020
Metrics
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This preprint is under consideration at Journal of Translational Medicine. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
The Role of Atherosclerotic Cardiovascular Risk Enhancers in the Prediction of Cardiovascular Events: Tehran Lipid and Glucose Study
Farzad Hadaegh
Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8935-2744
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version (no preprint)
Posted 04 Dec, 2020
Editorial decision: Minor revision
On 04 Dec, 2020
Review #3 received
Received 01 Dec, 2020
Reviewer #4 agreed
On 30 Nov, 2020
Reviewer #3 agreed
On 30 Nov, 2020
Review #1 received
Received 28 Nov, 2020
Review #2 received
Received 28 Nov, 2020
Reviewer #2 agreed
On 26 Nov, 2020
Editor assigned
On 26 Nov, 2020
Reviewers invited
Invitations sent on 26 Nov, 2020
Reviewer #1 agreed
On 26 Nov, 2020
Submission checks complete
On 26 Nov, 2020
Editor invited
On 26 Nov, 2020
This version was not preprinted
Version 1
Posted 28 Sep, 2020
Published
On 06 Jan, 2021
No community comments so far
Editorial decision: Major revision
On 17 Oct, 2020
Review #3 received
Received 13 Oct, 2020
Review #5 received
Received 11 Oct, 2020
Review #1 received
Received 03 Oct, 2020
Reviewers invited
Invitations sent on 02 Oct, 2020
Reviewer #1 agreed
On 02 Oct, 2020
Reviewer #2 agreed
On 02 Oct, 2020
Reviewer #3 agreed
On 02 Oct, 2020
Reviewer #4 agreed
On 02 Oct, 2020
Reviewer #5 agreed
On 02 Oct, 2020
Reviewer #6 agreed
On 02 Oct, 2020
Reviewer #7 agreed
On 02 Oct, 2020
Reviewer #8 agreed
On 02 Oct, 2020
Reviewer #9 agreed
On 02 Oct, 2020
Reviewer #10 agreed
On 02 Oct, 2020
Review #2 received
Received 02 Oct, 2020
Review #4 received
Received 02 Oct, 2020
Editor assigned
On 30 Sep, 2020
Editor invited
On 29 Sep, 2020
Submission checks complete
On 24 Sep, 2020
First submitted
On 19 Sep, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Translational Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Journal of Translational Medicine.
Background: To assess the effect of the atherosclerotic cardiovascular disease risk enhancing factors (ASCVD-REFs) on incident cardiovascular disease (CVD) events among non-diabetic individuals with borderline and intermediate ACC/AHA score during 10 and 15-year follow-up. Moreover, the added value of these ASCVD-REFs on the predictive power of the pooled cohort equations (PCE) was examined.
Methods: A total of 1204 adults aged 40-75 years, free from CVD at baseline with low-density lipoprotein cholesterol (LDL-C) between 70-189 mg/dl, were included. Unadjusted Cox regression analysis was used. The predictive ability of each significant ASCVD-REFs was estimated using the cut-point-free integrated discrimination improvement (IDI).
Results: During 10-year follow up, 181 CVD events (including 73 hard CVD) occurred. For hard CVD events, the high blood pressure (BP) component (i.e. ≥130/85 mmHg) of metabolic syndrome (Mets) (Hazard ratio: HR (95% CI; 1.67(1.03-2.70)) and positive history of preeclampsia (5.06(1.17-22.0)) were significant ASCVD-REFs. During the longer follow-up, Mets and its components of high waist circumference (WC) and high BP significantly increased the risk. As for CVD events, the Mets and its high BP and high WC components significantly increased the risk. However, in the ACC/AHA adjusted score, these covariates did not significantly improve the predictive power of the CVD or hard CVD.
Conclusions: The high BP was the most consistent and independent ASCVD-REFs in the prediction of all CVD and hard CVD, among the population with borderline/intermediate risk. Hence, considering pharmacologic therapies for patients with high BP and high LDL-C might be beneficial for preventive initiatives.
Figure 1
Figure 2