Abstract 4031: PDAY Risk Score Calculated In Young People Predicts Increased Carotid Artery Intima-Media Thickness In The Longitudinal Young Finns Study
BACKGROUND - A risk score formula to estimate the probability of advanced atherosclerosis using coronary heart disease (CHD) risk factors was developed for subjects 15–34 years of age by the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) study.
METHODS - The PDAY risk score was applied in the longitudinal Cardiovascular Risk in Young Finns Study. We examined whether PDAY risk score computed from modifiable risk factors in 1,279 subjects at ages 12–24 years (year 1986) would predict increased common carotid carotid intima-media thickness (IMT > the 90th percentile) 15 years later at ages 27 to 39 years (year 2001). We also examined the association of IMT with the change in risk score over the 15 year interval. The modifiable risk factors included non-HDL-cholesterol, HDL cholesterol, smoking, elevated blood pressure, obesity, and hyperglycemia/diabetes.
RESULTS - We analyzed the 1986 and 2001 risk scores together by considering as predictor variables the 1986 score and the change in risk score between 1986 and 2001. The risk score decreased in 20%, did not change in 17.5%, and increased in 62.5%. Only 39/1279 (3%) were taking lipid lowering or anti-hypertensive medication, only 1% of those with lowering of risk scores. The odds ratio (95% CI) for predicting increased IMT for a 1 point increase in PDAY risk score was 1.108 (1.036–1.186) due to the modifiable risk factors measured in 1986, and 1.064 (1.013–1.119) due to the change in modifiable risk factors measured between 2001 and 1986. The corresponding c-statistic was 0.684. Seventeen of the 1,279 subjects had a plaque in the carotid bulbus. The PDAY risk score in 1986 was a significant predictor of bulbus plaque with odds ratio of 1.188 (1.032–1.367) and c-statistics 0.670.
CONCLUSIONS -The PDAY risk score calculated in adolescents and young adults predicts the presence of increased carotid intima-media thickness and early carotid plaques 15 years later; lowering risk primarily through behavioral means lessens likelihood of high carotid IMT.