Author + information
- Emmanuel Akintoye,
- Alexandros Briasoulis and
- Luis Afonso
Background: We sought to develop a biomarker (BM) score for risk reclassification in intermediate-risk population (ASCVD score 5 to ≤7.5%)
Methods: Using the prospectively collected database of the Multi-ethnic Study of Atherosclerosis, we identified 6 biomarkers that predicted incident ASCVD independent of traditional risk factors. These were then combined in a multivariate Cox model to develop a BM score. The incremental benefit of the score over the pooled cohort equation (PCE) was evaluated using C-statistic, integrated discrimination index (IDI), and net reclassification index.
Results: Of 6458 asymptomatic adults (44-79 years) who had baseline measurement for these biomarkers, 964 (15%) were in the intermediate risk group based on the ASCVD risk score. The BM score significantly increased the C-statistic (0.761 vs 0.749, p=0.006) and discrimination slope of the PCE (IDI=0.005, p=0.01). Among the intermediate risk group, the BM score was associated with a graded increase in 10-year incident ASCVD, ranging from 2.5% in those with BM score of zero to 22% in those with BM score of ≥5 (fig 1). In addition, increasing BM score was associated with increasing hazard of events (fig 2) and its addition to the PCE results in 12% net reclassification among intermediate-risk group with LDL-C<190 mg/dl (p=0.04) (Table 1).
Conclusions: We developed a biomarker score that could be used to further reclassify patients in intermediate risk and aid decision-making during risk-benefit discussions for statin therapy
Moderated Poster Contributions
Prevention Moderated Poster Theater, Poster Hall, Hall C
Saturday, March 18, 2017, 4:15 p.m.-4:25 p.m.
Session Title: Innovations in Risk Assessment: Novel Biomarkers and Risk Prediction Tools
Abstract Category: 32. Prevention: Clinical
Presentation Number: 1261M-07
- 2017 American College of Cardiology Foundation