The risk and added values of the atherosclerotic cardiovascular risk enhancers on prediction of cardiovascular events: Tehran lipid and glucose study

Abstract Background In 2013 American College of Cardiology and the Heart Association released a guideline on management atherosclerotic cardiovascular disease (ASCVD) including composite death from CVD, non-fatal myocardial infarction, or stroke (hard CVD). This recommended risk score that was calculated using pooled cohort equations (ASCVD-PCE). The updated in 2018/2019 further discussion suggested for deciding whether to continue initiate statin therapy among non-diabetic individuals with ASCVD-PCE ranged 5–20%. They considering enhancing factors (ASCVD-REFs) family history premature chronic kidney disease, triglycerides ? 175 mg/dl, low-density lipoprotein cholesterol (LDL-C) 160 metabolic syndrome (Mets), women menopause, hypertensive disorders pregnancy (HDP). current study, we aimed examine predictability ASCVD-REFs incident hard CVD LDL-C 70-189 5–20% during 10 15-year follow-up. Methods A mong total 3546 aged 40-75 years, after excluding those < 5% 20% (n = 2342), 1204 (women 332) were included. univariable multivariable (further adjusted ASCVD-PCE) Cox regression analysis used evaluate association each potential CVD. Additionnaly, role different components Mets gestational diabetes (GDM)/macrosomia also examined. predictive ability significant ASCVD-REFs, then evaluated by discrimination accuracy reclassification index. Results During 10-year follow-up, 73 events occurred. Although analysis, high blood pressure (BP) component Mets, GDM/macrosomia, HDP remained as only (5.35 (1.22–23.38)) GDM/macrosomia (3.18 (1.05–9.65)) showed independent risks. (1.47 (1.05–2.06)) its waist circumference (1.40 (1.0–1.95)) BP (1.52 (1.07–2.15)) significantly increased risk. These did not improve ability. Conclusions decade conditions specific longer presence perse, WC shown ASCVD-REFs.