Abstract 20795: Assessing Atherosclerotic Cardiovascular Disease Risk in Population With Aortic Atherosclerosis
Background: Recent literature has shown that the pooled cohort equation (described in the 2013 ACC/AHA Guidelines on the Treatment of Blood Cholesterol) may overestimate atherosclerotic cardiovascular disease (ASCVD) risk. Aortic atherosclerosis has been associated with development of ASCVD and can be utilized as an additional risk factor to fully assess ASCVD risk.
Objective: This study compares the predicted ASCVD risk with that of actual ASCVD risk in patients with aortic atherosclerosis.
Method: We identified subjects with aortic atherosclerosis within an integrated health care system. Those with history of coronary artery disease or cerebrovascular disease were excluded. Utilizing the pooled cohort equation, estimated 1-year ASCVD risk was calculated for each patient (via annualized 10-year risk on the premise that ASCVD risk has been shown to be linear over a 10 year period) and compared to actual 1-year rate of death, myocardial infarction, or stroke.
Results: Our cohort was comprised of 13,105 patients. Mean age was 68 years. The median estimated 1-year ASCVD risk was 1.8% whereas median actual 1-year event rate was 6.6%. Across different ASCVD risk estimates, patients with aortic atherosclerosis persistently had a higher event rate than predicted (Figure).
Conclusion: In a large cohort of contemporary patients with aortic atherosclerosis, ACC/AHA pooled cohort equation substantially underestimates actual 1-year ASCVD events, implying that aortic atherosclerosis may be a non-traditional risk factor which bears consideration for primary prevention statin therapy.
Author Disclosures: R. Razi: None. M.B. Jorgensen: None. D. Yi: None. D. Zisook: None. S.S. Brar: None.
- © 2016 by American Heart Association, Inc.