Most of the patients presenting myocardial infarction would not be eligible for intensive lipid-lowering based on clinical algorithms or plasma C-reactive protein

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorSPOSITO, Andrei C.
dc.contributor.authorALVARENGA, Bruno Farah
dc.contributor.authorALEXANDRE, Alison S.
dc.contributor.authorARAUJO, Ana Laura Ribeiro
dc.contributor.authorSANTOS, Simone N.
dc.contributor.authorANDRADE, Joalbo M.
dc.contributor.authorRAMIRES, Jose A. F.
dc.contributor.authorSILVA, Jose C. Quinaglia e
dc.contributor.authorCOELHO, Otavio Rizzi
dc.contributor.groupauthorBrasilia Heart Study Grp
dc.date.accessioned2017-11-27T16:24:36Z
dc.date.available2017-11-27T16:24:36Z
dc.date.issued2011
dc.description.abstractObjective: The study we assessed how often patients who are manifesting a myocardial infarction (MI) would not be considered candidates for intensive lipid-lowering therapy based on the current guidelines. Methods: In 355 consecutive patients manifesting ST elevation MI (STEMI), admission plasma C-reactive protein (CRP) was measured and Framingham risk score (FRS), PROCAM risk score, Reynolds risk score, ASSIGN risk score, QRISK, and SCORE algorithms were applied. Cardiac computed tomography and carotid ultrasound were performed to assess the coronary artery calcium score (CAC), carotid intima-media thickness (cIMT) and the presence of carotid plaques. Results: Less than 50% of STEMI patients would be identified as having high risk before the event by any of these algorithms. With the exception of FRS (9%), all other algorithms would assign low risk to about half of the enrolled patients. Plasma CRP was <1.0 mg/L in 70% and >2 mg/L in 14% of the patients. The average cIMT was 0.8 +/- 0.2 mm and only in 24% of patients was >= 1.0 mm. Carotid plaques were found in 74% of patients. CAC > 100 was found in 66% of patients. Adding CAC >100 plus the presence of carotid plaque, a high-risk condition would be identified in 100% of the patients using any of the above mentioned algorithms. Conclusion: More than half of patients manifesting STEMI would not be considered as candidates for intensive preventive therapy by the current clinical algorithms. The addition of anatomical parameters such as CAC and the presence of carotid plaques can substantially reduce the CVD risk underestimation.
dc.description.indexMEDLINE
dc.description.sponsorshipBrazilian National Research Council (CNPq)
dc.identifier.citationATHEROSCLEROSIS, v.214, n.1, p.148-150, 2011
dc.identifier.doi10.1016/j.atherosclerosis.2010.10.034
dc.identifier.issn0021-9150
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/22740
dc.language.isoeng
dc.publisherELSEVIER IRELAND LTD
dc.relation.ispartofAtherosclerosis
dc.rightsrestrictedAccess
dc.rights.holderCopyright ELSEVIER IRELAND LTD
dc.subjectMyocardial infarction
dc.subjectAlgorithms
dc.subjectC-reactive protein
dc.subjectCoronary artery calcium
dc.subjectCarotid intima-media thickness
dc.subject.othercardiovascular-disease risk
dc.subject.otherintima-media thickness
dc.subject.otherscore
dc.subject.othervalidation
dc.subject.otherprediction
dc.subject.otherstatement
dc.subject.otherhistory
dc.subject.otherevents
dc.subject.othercohort
dc.subject.otherwomen
dc.subject.wosPeripheral Vascular Disease
dc.titleMost of the patients presenting myocardial infarction would not be eligible for intensive lipid-lowering based on clinical algorithms or plasma C-reactive protein
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.author.externalSPOSITO, Andrei C.:State Univ Campinas Unicamp, Fac Med Sci, Div Cardiol, BR-13084971 Campinas, SP, Brazil
hcfmusp.author.externalALVARENGA, Bruno Farah:Univ Brasilia, Med Sch UnB, Brasilia, DF, Brazil
hcfmusp.author.externalALEXANDRE, Alison S.:Univ Brasilia, Med Sch UnB, Brasilia, DF, Brazil
hcfmusp.author.externalARAUJO, Ana Laura Ribeiro:Univ Brasilia, Med Sch UnB, Brasilia, DF, Brazil
hcfmusp.author.externalSANTOS, Simone N.:Univ Brasilia, Med Sch UnB, Brasilia, DF, Brazil
hcfmusp.author.externalANDRADE, Joalbo M.:Univ Brasilia, Med Sch UnB, Brasilia, DF, Brazil
hcfmusp.author.externalSILVA, Jose C. Quinaglia e:Hosp Base Dist Fed, Brasilia, DF, Brazil
hcfmusp.author.externalCOELHO, Otavio Rizzi:State Univ Campinas Unicamp, Fac Med Sci, Div Cardiol, BR-13084971 Campinas, SP, Brazil
hcfmusp.citation.scopus15
hcfmusp.contributor.author-fmusphcJOSE ANTONIO FRANCHINI RAMIRES
hcfmusp.description.beginpage148
hcfmusp.description.endpage150
hcfmusp.description.issue1
hcfmusp.description.volume214
hcfmusp.origemWOS
hcfmusp.origem.pubmed21115179
hcfmusp.origem.scopus2-s2.0-78650837420
hcfmusp.origem.wosWOS:000285994600024
hcfmusp.publisher.cityCLARE
hcfmusp.publisher.countryIRELAND
hcfmusp.relation.referenceANDERSON KM, 1991, AM HEART J, V121, P293, DOI 10.1016/0002-8703(91)90861-B
hcfmusp.relation.referenceSposito AC, 2009, ATHEROSCLEROSIS, V207, P191, DOI 10.1016/j.atherosclerosis.2009.04.008
hcfmusp.relation.referenceNambi V, 2010, J AM COLL CARDIOL, V55, P1600, DOI 10.1016/j.jacc.2009.11.075
hcfmusp.relation.referenceStein JH, 2008, J AM SOC ECHOCARDIOG, V21, P93, DOI 10.1016/j.echo.2007.11.011
hcfmusp.relation.referenceBrook RD, 2010, CIRCULATION, V121, P2331, DOI 10.1161/CIR.0b013e3181dbece1
hcfmusp.relation.referenceHippisley-Cox J, 2007, BRIT MED J, V335, P136, DOI 10.1136/bmj.39261.471806.55
hcfmusp.relation.referenceRidker PM, 2007, JAMA-J AM MED ASSOC, V297, P611, DOI 10.1001/jama.297.6.611
hcfmusp.relation.referenceRidker PM, 2008, NEW ENGL J MED, V359, P2195, DOI 10.1056/NEJMoa0807646
hcfmusp.relation.referenceAssmann G, 2002, CIRCULATION, V105, P310, DOI 10.1161/hc0302.102575
hcfmusp.relation.referenceHouslay ES, 2006, HEART, V92, P1207, DOI 10.1136/hrt.2005.080929
hcfmusp.relation.referenceHippisley-Cox J, 2008, HEART, V94, P34, DOI 10.1136/hrt.2007.134890
hcfmusp.relation.referenceWoodward M, 2007, HEART, V93, P172, DOI 10.1136/hrt.2006.108167
hcfmusp.relation.referenceMunir JA, 2010, ATHEROSCLEROSIS, V211, P467, DOI 10.1016/j.atherosclerosis.2010.03.016
hcfmusp.relation.referenceRidker PM, 2008, CIRCULATION, V118, P2243, DOI 10.1161/CIRCULATIONAHA.108.814251
hcfmusp.relation.referenceGraham I, 2007, EUR HEART J, V28, P2375, DOI 10.1093/eurheartj/ehm316
hcfmusp.relation.referenceStein JH, 2008, J AM SOC ECHOCARDIOG, V21, P189, DOI 10.1016/J.ECH0.2007.11.011
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