Exercise Testing, Family History, and Subclinical Atherosclerosis Markers for Cardiovascular Risk Reclassification in Middle-Aged Women
| Autor: | Isly Maria Lucena de Barros, William Azem Chalela, Laura Olinda Bregieiro Fernandes Costa, Ulisses Ramos Montarroyos, Maria de Fátima Monteiro, Moacir de Novaes Lima Ferreira, Ana Kelley de Lima Medeiros, Rodrigo P. Pedrosa, Ricardo Quental Coutinho, Maria José Bezerra Guimarães, Ana Paula Dornelas Leão |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Heredity Myocardial Infarction Asymptomatic Sudden death Internal medicine medicine Women Obesity Myocardial infarction Family history Risk factor Cause of death Framingham Risk Score business.industry Risk Factor Estrogens Middle Aged Atherosclerosis medicine.disease Coronary Calcium Score Hypertension Exercise Test Cardiology medicine.symptom business |
| Zdroj: | International Journal of Cardiovascular Sciences v.34 n.4 2021 International Journal of Cardiovascular Sciences Sociedade Brasileira de Cardiologia (SBC) instacron:SBC International Journal of Cardiovascular Sciences, Issue: ahead, Published: 16 JUL 2021 International Journal of Cardiovascular Sciences, Volume: 34, Issue: 4, Pages: 383-392, Published: 16 JUL 2021 |
| ISSN: | 2359-5647 2359-4802 |
| DOI: | 10.36660/ijcs.20200414 |
| Popis: | Background Cardiovascular diseases are the main cause of death in women and the accuracy of currently available risk scores is questionable. Objective To reclassify the risk estimated by the Framingham Risk Score (FRS) in asymptomatic middle-aged women by incorporating family history, exercise testing variables, and subclinical atherosclerosis markers. Methods This cross-sectional study included 509 women (age range, 46-65 years) without cardiovascular symptoms. Those at low or intermediate risk by the FRS were reclassified to a higher level considering premature family history of acute myocardial infarction and/or sudden death; four variables from exercise testing; and two variables related to subclinical atherosclerosis markers. The homogeneity of these variables according to the FRS was verified by Pearson chi-square test (p10%) risks, respectively. The intermediate-risk stratum showed the highest increase (from 6.2% to 33.3%) with addition of family history; followed by addition of chronotropic index 0 (20.6%); decreased one-minute heart rate recovery ≤12 bpm (15.2%); carotid intima-media thickness >1 mm and/or carotid plaque (13.8%) and ST-segment depression (9.0%). The high-risk stratum increased to 14.4% with the addition of reduced heart rate recovery and to 17.1% with the coronary calcium score. Conclusion Incorporation of premature family history of cardiovascular events, exercise testing abnormal parameters, and subclinical atherosclerosis markers into the FRS led to risk reclassification in 3.0-29.7% of asymptomatic middle-aged women, mainly by an increase from low to intermediate risk. |
| Databáze: | OpenAIRE |
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