Assessing the Validity of the Criteria for the Extreme Risk Category of Atherosclerotic Cardiovascular Disease: A Nationwide Population-Based Study
1
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Objective: To validate the criteria for the extreme risk category for atherosclerotic cardiovascular disease (ASCVD). Methods: An observational cohort study of 35,464 individuals with established ASCVD was performed using the National Health Information Database. Incident myocardial infarction (MI), ischemic stroke, and death in patients with established ASCVD was investigated to validate the criteria for the extreme risk category of ASCVD defined as the presence of diabetes mellitus (DM), chronic kidney disease (CKD), and history of premature ASCVD. Results: Among 35,464 patients, 77.97% of them were classified into the extreme risk group of ASCVD. A total of 28.10%, 39.61%, and 32.12% had DM, CKD, and a history of premature ASCVD, respectively. During a mean follow-up of 8.39 years, MI, ischemic stroke, and all-cause death were found in 3.87%, 8.51%, and 23.98% of participants, respectively. In multivariate analysis, patients with DM had higher risk for MI (hazard ratio [HR], 1.62; 95% confidence interval [CI], 1.45-1.81), ischemic stroke (HR, 1.39; 95% CI, 1.29-1.50), and all-cause death (HR, 1.52; 95% CI, 1.45-1.59) than those without DM. Patients with CKD had 1.56 times higher risk for MI, 1.12 times higher risk for ischemic stroke, and 1.34 times higher risk for death than those without CKD. However, the risk for MI, ischemic stroke, and all-cause death was not different between patients with and without a history of premature ASCVD. Conclusion: DM and CKD, but not a history of premature ASCVD, could be considered as reasonable criteria of an extreme risk for ASCVD.
Abstract
Objective: To validate the criteria for the extreme risk category for atherosclerotic cardiovascular disease (ASCVD). Methods: An observational cohort study of 35,464 individuals with established ASCVD was performed using the National Health Information Database. Incident myocardial infarction (MI), ischemic stroke, and death in patients with established ASCVD was investigated to validate the criteria for the extreme risk category of ASCVD defined as the presence of diabetes mellitus (DM), chronic kidney disease (CKD), and history of premature ASCVD. Results: Among 35,464 patients, 77.97% of them were classified into the extreme risk group of ASCVD. A total of 28.10%, 39.61%, and 32.12% had DM, CKD, and a history of premature ASCVD, respectively. During a mean follow-up of 8.39 years, MI, ischemic stroke, and all-cause death were found in 3.87%, 8.51%, and 23.98% of participants, respectively. In multivariate analysis, patients with DM had higher risk for MI (hazard ratio [HR], 1.62; 95% confidence interval [CI], 1.45-1.81), ischemic stroke (HR, 1.39; 95% CI, 1.29-1.50), and all-cause death (HR, 1.52; 95% CI, 1.45-1.59) than those without DM. Patients with CKD had 1.56 times higher risk for MI, 1.12 times higher risk for ischemic stroke, and 1.34 times higher risk for death than those without CKD. However, the risk for MI, ischemic stroke, and all-cause death was not different between patients with and without a history of premature ASCVD. Conclusion: DM and CKD, but not a history of premature ASCVD, could be considered as reasonable criteria of an extreme risk for ASCVD.
참고문헌 (33)
- Virani SS, "Heart disease and stroke statistics-2020 update : a report from the American Heart Association", Circulation, 141, pp.e139~e596 (2020)
- 배재현, "Validation of Risk Prediction Models for Atherosclerotic Cardiovascular Disease in a Prospective Korean Community-Based Cohort", Diabetes and Metabolism Journal, 44(3), pp.458~469 (2020), 대한당뇨병학회
- 이승환, "Predicting the Development of Myocardial Infarction in Middle-Aged Adults with Type 2 Diabetes: A Risk Model Generated from a Nationwide Population-Based Cohort Study in Korea", Endocrinology and Metabolism, 35(3), pp.636~646 (2020), 대한내분비학회[DOI]
- 김효은, "Lipid-Lowering Efficacy and Safety of a New Generic Rosuvastatin in Koreans: an 8-Week Randomized Comparative Study with a Proprietary Rosuvastatin", 지질·동맥경화학회지, 9(2), pp.283~290 (2020), 한국지질동맥경화학회[DOI]
- 문재철, "Efficacy and Safety of High-Dose Atorvastatin in Moderate-to-High Cardiovascular Risk Postmenopausal Korean Women with Dyslipidemia", 지질·동맥경화학회지, 9(1), pp.162~171 (2020), 한국지질동맥경화학회[DOI]
- 김정선, "Associations of Dietary Intake with Cardiovascular Disease, Blood Pressure, and Lipid Profile in the Korean Population: a Systematic Review and Meta-Analysis", 지질·동맥경화학회지, 9(1), pp.205~229 (2020), 한국지질동맥경화학회[DOI]
- 남가은, "Obesity Fact Sheet in Korea, 2019: Prevalence of Obesity and Abdominal Obesity from 2009 to 2018 and Social Factors", Journal of Obesity & Metabolic Syndrome, 29(2), pp.124~132 (2020), 대한비만학회[DOI]
- Rosenblit PD, "Extreme atherosclerotic cardiovascular disease(ASCVD)risk recognition", Curr Diab Rep, 19, pp.61~ (2019)
- Criqui MH, "Mortality over a period of 10 years in patients with peripheral arterial disease", N Engl J Med, 326, pp.381~386 (1992)
- Wilterdink JL, "Vascular event rates in patients with atherosclerotic cerebrovascular disease", Arch Neurol, 49, pp.857~863 (1992)
- Cupples LA, "Preexisting cardiovascular conditions and long-term prognosis after initial myocardial infarction : the Framingham Study", Am Heart J, 125, pp.863~872 (1993)
- Kannel WB, "Risk factors for atherosclerotic cardiovascular outcomes in different arterial territories", J Cardiovasc Risk, 1, pp.333~339 (1994)
- 이은정, "2018 Guidelines for the Management of Dyslipidemia in Korea", 지질·동맥경화학회지, 8(2), pp.78~131 (2019), 한국지질동맥경화학회[DOI]
- Garber AJ, "Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the comprehensive type 2 diabetes management algorithm-2020 executive summary", Endocr Pract, 26, pp.107~139 (2020)
- Mach F, "2019 ESC", EAS guidelines for the management of dyslipidaemias : lipid modification to reduce cardiovascular risk, 2019, pp.290, 140~205
- Jellinger PS, "American Association of Clinical Endocrinologists and American College of Endocrinology guidelines for management of dyslipidemia and prevention of cardiovascular disease", Endocr Pract, 23, pp.1~87 (2017)
- Rallidis LS, "Extreme-risk category : high prevalence among stable coronary patients and an emerging widening treatment gap in achieving LDL-cholesterol less than 55 mg", dL, 2018, pp.275, 262~264
- Howard BV, "Coronary heart disease risk equivalence in diabetes depends on concomitant risk factors", Diabetes Care, 29, pp.391~397 (2006)
- Preiss D, "A systematic review of event rates in clinical trials in diabetes mellitus : the importance of quantifying baseline cardiovascular disease history and proteinuria and implications for clinical trial design", Am Heart J, 161, pp.210~219 (2011)
- Emerging Risk Factors Collaboration, "Association of cardiometabolic multimorbidity with mortality", JAMA, 314, pp.52~60 (2015)
- Sabatine MS, "Evolocumab and clinical outcomes in patients with cardiovascular disease", N Engl J Med, 376, pp.1713~1722 (2017)
- Newman JD, "Diabetes mellitus is a coronary heart disease risk equivalent for peripheral vascular disease", Am Heart J, 184, pp.114~120 (2017)
- Jacobson TA, "National lipid association recommendations for patient-centered management of dyslipidemia : part 1--full report", J Clin Lipidol, 9, pp.129~169 (2015)
- Briasoulis A, "Chronic kidney disease as a coronary artery disease risk equivalent", Curr Cardiol Rep, 15, pp.340~ (2013)
- Baigent C, "The effects of lowering LDL cholesterol with simvastatin plus ezetimibe in patients with chronic kidney disease(Study of Heart and Renal Protection) : a randomised placebo-controlled trial", Lancet, 377, pp.2181~2192 (2011)
- Wanner C, "Atorvastatin in patients with type 2 diabetes mellitus undergoing hemodialysis", N Engl J Med, 353, pp.238~248 (2005)
- Fellström BC, "Rosuvastatin and cardiovascular events in patients undergoing hemodialysis", N Engl J Med, 360, pp.1395~1407 (2009)
- Sun F, "Metabolic syndrome and the development of chronic kidney disease among 118 924 non-diabetic Taiwanese in a retrospective cohort", Nephrology(Carlton), 15, pp.84~92 (2010)
- Mason JC, "Cardiovascular disease in patients with chronic inflammation : mechanisms underlying premature cardiovascular events in rheumatologic conditions", Eur Heart J, 36, pp.482~489 (2015)
- Long A, "Non-traditional risk factors for atherosclerotic disease : a review for emergency physicians", Am J Emerg Med, 36, pp.494~497 (2018)
- Yang J, "Risk factors and outcomes of very young adults who experience myocardial infarction : the partners YOUNG-MI registry", Am J Med, 133, pp.605~612 (2020)
- Mahtta D, "Premature atherosclerotic cardiovascular disease : What have we learned recently?", Curr Atheroscler Rep, 22, pp.44~ (2020)
- Mahtta D, "Evaluation of aspirin and statin therapy use and adherence in patients with premature atherosclerotic cardiovascular disease", JAMA Netw Open, 3, pp.e2011051~ (2020)