Atherosclerotic cardiovascular disease risk among Ghanaians: A comparison of the risk assessment tools.

Autor:	Agyekum F; Department of Medicine, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana.; Department of Medicine, Korle-Bu Teaching Hospital, Accra, Ghana., Akumiah FK; Department of Medicine, Korle-Bu Teaching Hospital, Accra, Ghana.; National Cardiothoracic Centre, Korle-Bu Teaching Hospital, Accra, Ghana., Nguah SB; Department of Child Health, Kwame Nkrumah University, Komfo Anokye Teaching Hospital, Kumasi, Ghana., Appiah LT; Department of Medicine, School of Medicine and Dentistry, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana., Ganatra K; Department of Medicine, Korle-Bu Teaching Hospital, Accra, Ghana.; National Cardiothoracic Centre, Korle-Bu Teaching Hospital, Accra, Ghana., Adu-Boakye Y; Department of Medicine, School of Medicine and Dentistry, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana., Folson AA; Department of Medicine, University of Health and Allied Sciences, Ho, Volta Region, Ghana., Ayetey H; Department of Medicine, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana., Owusu IK; Department of Medicine, School of Medicine and Dentistry, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Jazyk:	angličtina
Zdroj:	American journal of preventive cardiology [Am J Prev Cardiol] 2024 Apr 18; Vol. 18, pp. 100670. Date of Electronic Publication: 2024 Apr 18 (Print Publication: 2024).
DOI:	10.1016/j.ajpc.2024.100670
Abstrakt:	Objectives: Risk stratification is a cornerstone for preventing atherosclerotic cardiovascular disease (ASCVD). Ghana has yet to develop a locally derived and validated ASCVD risk model. A critical first step towards this goal is assessing how the commonly available risk models perform in the Ghanaian population. This study compares the agreement and correlation between four ASCVD risk assessment models commonly used in Ghana. Methods: The Ghana Heart Study collected data from four regions in Ghana (Ashanti, Greater Accra, Northern, and Central regions) and excluded people with a self-declared history of ASCVD. The 10-year fatal/non-fatal ASCVD risk of participants aged 40-74 was calculated using mobile-based apps for Pooled Cohort Equation (PCE), laboratory-based WHO/ISH CVD risk, laboratory-based Framingham risk (FRS), and Globorisk, categorizing them as low, intermediate, or high risk. The risk categories were compared using the Kappa statistic and Spearman correlation. Results: A total of 615 participants were included in this analysis (median age 55 [Inter quartile range 46, 64]) years with 365 (59.3 %) females. The WHO/ISH risk score categorized 504 (82.0 %), 58 (9.4 %), and 53 (8.6 %) as low-, intermediate-, and high-risk, respectively. The PCE categorized 345 (56.1 %), 181 (29.4 %), and 89 (14.5 %) as low-, intermediate- and high-risk, respectively. The Globorisk categorized 236 (38.4 %), 273 (44.4 %), and 106 (17.2 %) as low-, intermediate-, and high-risk, respectively. Significant differences in the risk categorization by region of residence and age group were noted. There was substantial agreement between the PCE vs FRS (Kappa = 0.8, 95 % CI 0.7 - 0.8), PCE vs Globorisk (Kappa = 0.6; 95 % CI 0.6 - 0.7), and FRS vs Globorisk (Kappa = 0.6; 95 % CI 0.6 - 0.7). However, there was only fair agreement between the WHO vs Globorisk (Kappa = 0.3; 95 % CI 0.3-0.4) and moderate agreement between the WHO vs PCE and WHO vs FRS. Conclusion: There are significant differences in the ASCVD risk prediction tools in the Ghanaian population, posing a threat to primary prevention. Therefore, there is a need for locally derived and validated tools. Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© 2024 The Author(s).)
Databáze:	MEDLINE
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