Dataset Information

Layperson-Oriented versus Clinical-Based Models for Assessing 10-Year Incidence of Coronary Heart Disease: National FINRISK Study.

ABSTRACT: One laboratory-based and two non-laboratory-based models with and without blood pressure measures are developed based on data of 14815 men and 16617 women aged 25-64 years. During the followup 1134 men and 566 women developed coronary heart disease (CHD). The area under the receiver operating characteristic curve (95% CI) for prediction of CHD incidence was 0.823 (0.807-0.839) for the laboratory-based model, 0.808 (0.791-0.824) and 0.803 (0.787-0.820) for the non-laboratory-based models with and without systolic blood pressure in men (P < 0.01 for overall comparison), and 0.878 (0.856-0.901), 0.871 (0.848-0.894), and 0.864 (0.840-0.887), respectively, in women (P < 0.01). The predicted rates matched well with the observed ones (P > 0.10). Compared with the model without blood pressure, the non-laboratory-based model with blood pressure tended to reclassify individuals into the higher risk categories for both event and nonevent groups in both genders. The study concludes the predictive property of the non-laboratory-based models are good.

SUBMITTER: Qiao Q

PROVIDER: S-EPMC3199110 | biostudies-literature | 2011

REPOSITORIES: biostudies-literature

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Layperson-Oriented versus Clinical-Based Models for Assessing 10-Year Incidence of Coronary Heart Disease: National FINRISK Study.

Qiao Qing Q Laatikainen Tiina T Gao Weiguo W Pitkäniemi Janne J Vartiainen Erkki E

International journal of vascular medicine 20111019

One laboratory-based and two non-laboratory-based models with and without blood pressure measures are developed based on data of 14815 men and 16617 women aged 25-64 years. During the followup 1134 men and 566 women developed coronary heart disease (CHD). The area under the receiver operating characteristic curve (95% CI) for prediction of CHD incidence was 0.823 (0.807-0.839) for the laboratory-based model, 0.808 (0.791-0.824) and 0.803 (0.787-0.820) for the non-laboratory-based models with and ...[more]

PMID: 22028973

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Project description:Background Data in the literature on acute coronary syndrome in sub-Saharan Africa are scarce. Methods and Results We conducted a systematic review of the MEDLINE (PubMed) database of observational studies of acute coronary syndrome in sub-Saharan Africa from January 1, 2010 to June 30, 2020. Acute coronary syndrome was defined according to current definitions. Abstracts and then the full texts of the selected articles were independently screened by 2 blinded investigators. This systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards. We identified 784 articles with our research strategy, and 27 were taken into account for the final analysis. Ten studies report a prevalence of acute coronary syndrome among patients admitted for cardiovascular disease ranging from 0.21% to 22.3%. Patients were younger, with a minimum age of 52 years in South Africa and Djibouti. There was a significant male predominance. Hypertension was the main risk factor (50%-55% of cases). Time to admission tended to be long, with the longest times in Tanzania (6.6 days) and Burkina Faso (4.3 days). Very few patients were admitted by medicalized transport, particularly in Côte d'Ivoire (only 34% including 8% by emergency medical service). The clinical presentation is dominated by ST-elevation sudden cardiac arrest. Percutaneous coronary intervention is not widely available but was performed in South Africa, Kenya, Côte d'Ivoire, Sudan, and Mauritania. Fibrinolysis was the most accessible means of revascularization, with streptokinase as the molecule of choice. Hospital mortality was highly variable between 1.2% and 24.5% depending on the study populations and the revascularization procedures performed. Mortality at follow-up varied from 7.8% to 43.3%. Some studies identified factors predictive of mortality. Conclusions The significant disparities in our results underscore the need for a multicenter registry for acute coronary syndrome in sub-Saharan Africa in order to develop consensus-based strategies, propose and evaluate tailored interventions, and identify prognostic factors.

Project description:BackgroundOctogenarians and beyond have often been neglected in the populational study of disease despite being at the highest point of non-modifiable disease risk burden and the fastest-growing age group for the past decade. This study examined the characteristics and in-hospital management of octogenarian patients with acute coronary syndrome (ACS) in a multi-ethnic, middle-income country in South East Asia.MethodThis retrospective study utilised the Malaysian National Cardiovascular Disease- ACS (NCVD-ACS) registry. Consecutive patient data of those ≥80 years old admitted with ACS at 24 participating hospitals from 2008 to 2017 (n = 3162) were identified. Demographics, in-hospital intervention, and evidence-based pharmacotherapies over the 10-years were examined and compared across groups of interests using the Chi-square test. Multivariate logistic regression was used to calculate the adjusted odds ratio of receiving individual therapies according to patients' characteristics.ResultsOctogenarians made up 3.8% of patients with ACS in the NCVD-ACS registry (mean age = 84, SD ± 3.6) from 2008 until 2017. The largest ethnic group was Chinese (44%). Most octogenarians (95%) have multiple cardiovascular risk factors, with hypertension (82%) being the main. Non-ST-elevation myocardial infarction (NSTEMI) predominated (38%, p < 0.001). Within the 10-year, there were positive increments in cardiovascular intervention and pharmacotherapies. Only 10% of octogenarians with ACS underwent percutaneous coronary intervention (PCI), the majority being STEMI patients (17.5%; p < 0.05). More than 80% were prescribed aspirin (91.3%) either alone or combined, dual antiplatelet therapy (DAPT) (83.3%), anticoagulants (89.7%) and statins (89.6%), while less being prescribed angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (47.6%) and beta-blockers (43.0%). Men were more likely to receive PCI than women (adjusted Odds Ratio (aOR): 0.698; 95% CI: 0.490-0.993). NSTEMI (aOR = 0.402, 95% CI: 0.278-0.583) and unstable angina (UA) (aOR = 0.229, 95% CI: 0.143-0.366) were less likely to receive PCI but more likely given anticoagulants (NSTEMI, aOR = 1.543, 95% CI: 1.111-2.142; UA, aOR = 1.610, 95% CI: 1.120-2.314) than STEMI. The presence of cardiovascular risk factors and comorbidities influences management.ConclusionOctogenarians with ACS in this country were mainly treated with cardiovascular pharmacotherapies. As the number of octogenarians with ACS will continue to increase, the country needs to embrace the increasing use of PCI in this group of patients.

Dataset Information

Layperson-Oriented versus Clinical-Based Models for Assessing 10-Year Incidence of Coronary Heart Disease: National FINRISK Study.

Publications

Layperson-Oriented versus Clinical-Based Models for Assessing 10-Year Incidence of Coronary Heart Disease: National FINRISK Study.

Similar Datasets

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