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Epicardial adipose tissue volume improves cardiovascular risk reclassification: the Framingham Risk Score example
Session:
Posters - J. Preventive Cardiology
Speaker:
Joao Adriano Sousa
Congress:
CPC 2021
Topic:
J. Preventive Cardiology
Theme:
28. Risk Factors and Prevention
Subtheme:
28.2 Risk Factors and Prevention – Cardiovascular Risk Assessment
Session Type:
Posters
FP Number:
---
Authors:
Joao Adriano Sousa; Isabel Mendonça; Marina Santos; Margarida Temtem; Flávio Mendonça; Ana Célia Sousa; Mariana Rodrigues; Eva Henriques; Sónia Freitas; Sofia Borges; Graça Guerra; António Drumond; Roberto Palma Dos Reis
Abstract
<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Garamond",serif">Introduction:</span></strong><span style="font-family:"Garamond",serif"> Epicardial adipose tissue (EAT) volume can be noninvasively detected by CT and has been suggested to predict major adverse cardiovascular events (MACE). Framingham Risk Score </span><span style="font-size:10.5pt"><span style="background-color:white"><span style="font-family:"Garamond",serif"><span style="color:#202122">is one of a number of scoring systems used to determine an individual's chances of developing cardiovascular disease, hence identifying who is most likely to benefit from prevention.</span></span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Garamond",serif">Objectives:</span></strong><span style="font-family:"Garamond",serif"> The purpose of this study was to determine net reclassification improvement (NRI) and improved risk prediction based on EAT volume, in comparison to a traditionally known cardiovascular risk score, such as the Framingham.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Garamond",serif">Methods:</span></strong><span style="font-family:"Garamond",serif"> 895 asymptomatic volunteers were prospectively enrolled in a single Portuguese center (mean age 51.9 ± 7.7, 78.5% male) and underwent a median follow-up time of 3.7 years (IQR 5.0). EAT volume was measured by Cardiac Computed Tomography (CCT) using a modified simplified method. For NRI assessment, EAT volume as a continuous variable was added to the Framingham Risk Score.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Garamond",serif">Results:</span></strong><span style="font-family:"Garamond",serif"> After 3.7 median years of follow-up, 27 patients developed a MACE. Using NRI, the net proportion of events (netNRIe) that assigned a higher risk was 33.3% (better reclassified), and the net ratio of non-events (netNRIne) was 24.7%, resulting in a net reclassification index (netNRI) of 58.0%. When the new marker was included in the model, 58.0% of patients were better reclassified. In our work, a total of 33.3% of patients who suffered events (n=27) were correctly reclassified and assigned a higher risk. </span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Garamond",serif">Conclusion:</span></strong><span style="font-family:"Garamond",serif"> EAT volume results in a high reclassification rate in an asymptomatic, low-risk population, demonstrating the benefit of this marker beyond traditional risk assessment models. Our study supports its application, especially in carefully selected individuals.</span></span></span></p>
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