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Cardiovascular Events Prediction by Risk Factors

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (25 September 2022) | Viewed by 10462

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Special Issue Editors

Dr. Jaume Marrugat

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Guest Editor

1. REGICOR Research Group at Hospital del Mar Biomedical Research Institute (IMIM), Barcelona, Spain
2. CIBER (Centro de Investigación Biomédica en Red) of Cardiovascular Diseases (CIBERCV), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
Interests: cardiovascular epidemiology; cardiovascular risk functions; biomarkers; cardiovascular risk factors

Dr. Irene R. Degano

E-Mail Website1 Website2
Guest Editor

1. CIBER (Centro de Investigación Biomédica en Red) of Cardiovascular Diseases (CIBERCV), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
2. REGICOR Research Group at Hospital del Mar Biomedical Research Institute (IMIM), Barcelona, Spain
3. Faculty of Medicine, University of Vic – Central University of Catalonia (UVic-UCC), VIC, Spain
Interests: cardiovascular epidemiology; cardiovascular risk functions; biomarkers; cardiovascular risk factors; statistical methods; omics data analysis

Special Issue Information

Dear Colleagues,

Since the identification and description of the five most important cardiovascular risk factors more than 50 years ago by the Framingham Heart Study investigators, dozens of factors have been found to be associated with cardiovascular events. However, only a handful of them significantly improve cardiovascular risk prediction.

The Journal of Clinical Medicine (IF 4.241) has planned a Special Issue to update what we know about the predictive capacity of all types of risk factors and biomarkers, including biochemical, genetic, socioeconomic, lifestyle, and about the use of imaging and treatments to control cardiovascular risk. We are convinced that, as an expert in the field, you can make an important contribution to this Special Issue in the form of a review or an original article containing your own research on primary or secondary prevention of cardiovascular diseases by controlling their risk factors.

We look forward to receiving your contributions.

Dr. Jaume Marrugat
Dr. Irene R. Degano
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

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Keywords

risk factor
biomarker
risk function
coronary artery disease
stroke
incidence

Published Papers (5 papers)

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Research

9 pages, 231 KiB

Open AccessFeature PaperArticle

Reduction of Ischemic Stroke Associated Disability in the Population: A State-Wide Stroke Registry Analysis over a Decade

by Christian Foerch, Martin A. Schaller-Paule, Helmuth Steinmetz, Björn Misselwitz and Ferdinand O. Bohmann

J. Clin. Med. 2022, 11(23), 6942; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11236942 - 25 Nov 2022

Cited by 2 | Viewed by 1333

Abstract

(Background): Effective prevention strategies and acute therapies have been established and distributed in recent years to reduce the global burden of stroke. However, beyond randomized clinical trials, limited data exist on the real-world impact of these measures. Our goal was to analyze whether the stroke-associated disability in the population decreased over time based on a state-wide stroke registry analysis. (Methods): Consecutive data from a state-wide inpatient stroke registry covering the entire federal state of Hesse, Germany, were obtained. The clinical data of 141,287 patients with ischemic stroke (ICD-10: I63) admitted between 2010 and 2019 were included. The primary outcome was the odds ratio for a change of modified Ranking Scale (mRS) at discharge over time, estimated by ordinary logistic regression and adjusted for age and sex. The secondary outcome was the odds ratio for a lower National Institutes of Health Stroke Scale (NIHSS) score at hospital admission. (Results): The absolute number of severely disabled (mRS 4–5) stroke patients at discharge decreased over time (2010: 3223 (equivalent to 53/100,000 population); 2019: 2429 [39/100,000 population]). The odds at hospital admission for a higher mRS at discharge decreased significantly by 3.7% per year (OR 0.963 (95% CI 0.960–0.966), p < 0.001). The absolute number of severely affected stroke patients (NIHSS > 15) at admission declined over time (2010: 1589 [26/100,000]; 2019: 1185 [19/100,000]; p < 0.001). The odds for a higher NIHSS score at admission to hospital decreased by 3.8% per year (OR 0.962 (95% CI 0.959–0.965), p < 0.001). Trends were most prominent for patients aged 80 years and older and for patients with atrial fibrillation but absent in patients <60 years. (Conclusions): Stroke-associated disability in the population steadily decreased between 2010 and 2019. The improved prevention of severe strokes in elderly patients may be a major driver of this observation. Full article

(This article belongs to the Special Issue Cardiovascular Events Prediction by Risk Factors)

15 pages, 1071 KiB

Open AccessArticle

High Uric Acid Levels in Acute Myocardial Infarction Provide Better Long-Term Prognosis Predictive Power When Combined with Traditional Risk Factors

by Soohyun Kim, Byung-Hee Hwang, Kwan Yong Lee, Chan Jun Kim, Eun-Ho Choo, Sungmin Lim, Jin-Jin Kim, Ik Jun Choi, Mahn-Won Park, Gyu Chul Oh, Ki Dong Yoo, Wook Sung Chung, Youngkeun Ahn, Myung Ho Jeong and Kiyuk Chang

J. Clin. Med. 2022, 11(19), 5531; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11195531 - 21 Sep 2022

Cited by 1 | Viewed by 1768

Abstract

The current study aimed to investigate the association between serum UA levels and the mortality rate of AMI patients. We analyzed 5888 patients with successfully revascularized AMI (mean age: 64.0 ± 12.7 years). The subjects were divided into the high UA group (uric acid >6.5 mg/dL for males, >5.8 mg/dL for females) or the normal UA group based on initial serum UA level measured at admission. The primary outcome was all-cause mortality. A total of 4141 (70.3%) and 1747 (29.7%) patients were classified into the normal UA group and high UA groups, respectively. Over a median follow-up of 5.02 (3.07, 7.55) years, 929 (21.5%) and 532 (34.1%) patients died in each group. Cox regression analysis identified high UA levels as an independent predictor of all-cause mortality (unadjusted hazard ratio (HR) 1.69 [95% CI 1.52–1.88]; p < 0.001, adjusted HR 1.18 [95% CI: 1.05–1.32]; p = 0.005). The results were consistent after propensity-score matching and inverse probability weighting to adjust for baseline differences. The predictive accuracies of conventional clinical factor discrimination and reclassification were significantly improved upon the addition of hyperuricemia (C-index 0.788 [95% CI 0.775–0.801]; p = 0.005, IDI 0.004 [95% CI 0.002–0.006]; p < 0.001, NRI 0.263 [95% CI 0.208–0.318]; p < 0.001). Full article

(This article belongs to the Special Issue Cardiovascular Events Prediction by Risk Factors)

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15 pages, 378 KiB

Open AccessArticle

Identification of Risk Factors for Coronary Artery Disease in Asymptomatic Patients with Type 2 Diabetes Mellitus

by Kazuhisa Takamura, Shinichiro Fujimoto, Tomoya Mita, Yuko Okano Kawaguchi, Mika Kurita, Satoshi Kadowaki, Yuki Kamo, Chihiro Aoshima, Yui Okada Nozaki, Daigo Takahashi, Ayako Kudo, Makoto Hiki, Nobuo Tomizawa, Fuki Ikeda, Hiroaki Satoh, Hirotaka Watada and Tohru Minamino

J. Clin. Med. 2022, 11(5), 1226; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11051226 - 24 Feb 2022

Cited by 2 | Viewed by 2282

Abstract

Background: Patients with diabetes mellitus (DM) are a high-risk group for coronary artery disease (CAD). In the present study, we investigated predictive factors to identify patients at high risk of CAD among asymptomatic patients with type 2 DM based on coronary computed tomographic angiography (CCTA) findings. Methods: A single-center prospective study was performed on 452 consecutive patients with type 2 DM who were provided with a weekly hospital-based diabetes education program between 3 October 2015, and 31 March 2020. A total of 161 consecutive asymptomatic patients (male/female: 111/50, age: 57.3 ± 9.3 years) with type 2 DM without any known CAD underwent CCTA. Based on conventional coronary risk factors and non-invasive examination, i.e., measurement of intima-media thickness, subcutaneous and visceral fat area, a stress electrocardiogram test, and the Agatston score, patients with obstructive CAD, CT-verified high-risk plaques (CT-HRP), and optimal revascularization within 90 days were evaluated. Results: Current smoking (OR, 4.069; 95% C.I., 1.578–10.493, p = 0.0037) and the Agatston score ≥100 (OR, 18.034; 95% C.I., 6.337–51.324, p = 0.0001) were independent predictive factors for obstructive CAD, while current smoking (OR, 5.013; 95% C.I., 1.683–14.931, p = 0.0038) was an independent predictive factor for CT-HRP. Furthermore, insulin treatment (OR, 5.677; 95% C.I., 1.223–26.349, p = 0.0266) was the only predictive factor that correlated with optimal revascularization within 90 days. Conclusions: In asymptomatic patients with type 2 DM, current smoking, an Agatston score ≥100, and insulin treatment were independent predictive factors of patients being at high-risk for CAD. However, non-invasive examinations except for Agatston score were not independent predictors of patients being at high risk of CAD. Full article

(This article belongs to the Special Issue Cardiovascular Events Prediction by Risk Factors)

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9 pages, 462 KiB

Open AccessArticle

Usefulness of Cardiac Computed Tomography in Coronary Risk Prediction: A Five-Year Follow-Up of the SPICA Study (Secure Prevention with Imaging of the Coronary Arteries)

by David Viladés-Medel, Irene R. Dégano, Isaac Subirana, Martin Descalzo, Mireia Padilla, Xavier Mundet, Francesc Carreras Costa, Xavier Alomar Serrallach, Anna Camps, Roberto Elosua, Jaume Marrugat and Rubén Leta Petracca

J. Clin. Med. 2022, 11(3), 533; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11030533 - 21 Jan 2022

Cited by 4 | Viewed by 1587

Abstract

Accurate identification of individuals at high coronary risk would reduce acute coronary syndrome incidence and morbi-mortality. We analyzed the effect on coronary risk prediction of adding coronary artery calcification (CAC) and Segment Involvement Score (SIS) to cardiovascular risk factors. This was a prospective cohort study of asymptomatic patients recruited between 2013–2017. All participants underwent a coronary computed tomography angiography to determine CAC and SIS. The cohort was followed-up for a composite endpoint of myocardial infarction, coronary angiography and/or revascularization (median = five years). Discrimination and reclassification of the REGICOR function with CAC/SIS were examined with the Sommer’s D index and with the Net reclassification index (NRI). Nine of the 251 individuals included had an event. Of the included participants, 94 had a CAC = 0 and 85 a SIS = 0, none of them had an event. The addition of SIS or of SIS and CAC to the REGICOR risk function significantly increased the discrimination capacity from 0.74 to 0.89. Reclassification improved significantly when SIS or both scores were included. CAC and SIS were associated with five-year coronary event incidence, independently of cardiovascular risk factors. Discrimination and reclassification of the REGICOR risk function were significantly improved by both indexes, but SIS overrode the effect of CAC. Full article

(This article belongs to the Special Issue Cardiovascular Events Prediction by Risk Factors)

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9 pages, 569 KiB

Open AccessArticle

Clinical Characteristics and Predictors of All-Cause Mortality in Patients with Hypertensive Urgency at an Emergency Department

by Jeong-Hun Shin, Byung Sik Kim, Minhyung Lyu, Hyun-Jin Kim, Jun Hyeok Lee, Jin-kyu Park, Young-Hyo Lim and Jinho Shin

J. Clin. Med. 2021, 10(19), 4314; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10194314 - 22 Sep 2021

Cited by 12 | Viewed by 2697

Abstract

Hypertensive urgency is characterized by an acute increase in blood pressure without acute target organ damage, which is considered to be managed with close outpatient follow-up. However, limited data are available on the prognosis of these cases in emergency departments. We investigated the characteristics and predictors of all-cause mortality in Korean emergency patients with hypertensive urgency. This cross-sectional study included patients aged ≥18 years who visited an emergency tertiary referral center between January 2016 and December 2019 for hypertensive urgency, which was defined as a systolic blood pressure of ≥180 mmHg and a diastolic blood pressure of ≥110 mmHg, or both, without acute target organ damage. The 1 and 3 year all-cause mortality rates were 6.8% and 12.1%, respectively. The incidence of emergency department revisits and readmission after 3 months and 1 year was significantly higher in non-survivors than in survivors. In a multivariate analysis, age ≥ 60 years (hazard ratio (HR), 16.66; 95% CI, 6.20–44.80; p < 0.001), male sex (HR, 1.54; 95% CI, 1.22–1.94; p < 0.001), history of chronic kidney disease (HR, 2.18; 95% CI, 1.53–3.09; p < 0.001), and proteinuria (HR, 1.94; 95% CI, 1.53–2.48; p < 0.001) were independent predictors of 3 year all-cause mortality. The all-cause mortality rate of hypertensive urgency remains high despite the increased utilization of antihypertensive medications. Old age, male sex, history of chronic kidney disease, and proteinuria were poor prognostic factors for all-cause mortality in patients with hypertensive urgency. Full article

(This article belongs to the Special Issue Cardiovascular Events Prediction by Risk Factors)

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