Distribution of Traditional and Novel Risk Factors and Their Relation to Subsequent Cardiovascular Events in Patients With Acute Coronary Syndromes (from the PROVE IT-TIMI 22 Trial)

Current guidelines recommend risk stratification largely based on traditional risk factors such as those in the Framingham Risk Score. We studied the distribution of 12 traditional and non-traditional risk markers (age ≥65 years, male gender, family history of premature coronary heart disease, low-d...

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Bibliographic Details
Published in:The American journal of cardiology 2010-03, Vol.105 (5), p.619-623
Main Authors: Acharjee, Subroto, MBBS, Qin, Jie, MS, Murphy, Sabina A., MPH, McCabe, Carolyn, BS, Cannon, Christopher P., MD
Format: Article
Language:English
Subjects:
Acute Coronary Syndrome - etiology
Acute Coronary Syndrome - mortality
Acute Coronary Syndrome - therapy
Acute coronary syndromes
Aged
Atorvastatin Calcium
Biological and medical sciences
Cardiology. Vascular system
Cardiovascular
Cardiovascular disease
Cholesterol
Cholesterol - blood
Clinical trials
Cohort Studies
Coronary heart disease
Female
Heart
Heptanoic Acids - therapeutic use
Hospitalization
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Low density lipoprotein
Male
Medical sciences
Middle Aged
Myocardial Infarction - epidemiology
Myocardial Revascularization
Myocarditis. Cardiomyopathies
Pravastatin - therapeutic use
Pyrroles - therapeutic use
Risk Factors
Stroke - epidemiology
Treatment Outcome
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Summary:Current guidelines recommend risk stratification largely based on traditional risk factors such as those in the Framingham Risk Score. We studied the distribution of 12 traditional and non-traditional risk markers (age ≥65 years, male gender, family history of premature coronary heart disease, low-density lipoprotein cholesterol ≥70 mg/dl, high-density lipoprotein cholesterol 150 mg/dl, prediabetes defined as a fasting glucose level 100 to 125 mg/dl or hemoglobin A1c >6, and obesity defined as body mass index ≥30 kg/m2 ) in 3,675 patients from the PROVE IT-TIMI 22 trial at 4 months and evaluated the risk of cardiovascular events stratified by the number of risk factors. The median number of risk factors was 5. In individual risk factor subgroups, men, smokers, hypertensives, and patients with increased low-density lipoprotein cholesterol had just that added risk factor compared to their counterparts (median 5 vs 4). In contrast, patients with diabetes, prediabetes, and increased triglycerides, C-reactive protein, or body mass index had not only that, but also another added risk factor (median 6 vs 4). A higher risk factor count was strongly related with increased rate of death, myocardial infarction, unstable angina, stroke, or revascularization, from 0% to 38.6% at 2 years for 0 to ≥9 risk factors (p
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2009.10.042