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Risk Reclassification

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https://www.readbyqxmd.com/read/28107349/using-breast-cancer-risk-associated-polymorphisms-to-identify-women-for-breast-cancer-chemoprevention
#1
Elad Ziv, Jeffrey A Tice, Brian Sprague, Celine M Vachon, Steven R Cummings, Karla Kerlikowske
BACKGROUND: Breast cancer can be prevented with selective estrogen receptor modifiers (SERMs) and aromatase inhibitors (AIs). The US Preventive Services Task Force recommends that women with a 5-year breast cancer risk ≥3% consider chemoprevention for breast cancer. More than 70 single nucleotide polymorphisms (SNPs) have been associated with breast cancer. We sought to determine how to best integrate risk information from SNPs with other risk factors to risk stratify women for chemoprevention...
2017: PloS One
https://www.readbyqxmd.com/read/28106470/grace-score-validation-in-predicting-hospital-mortality-analysis-of-the-role-of-sex
#2
Eva de-Miguel-Balsa, Jaime Latour-Pérez, Anna Baeza-Román, Cristina Amorós-Verdú, Juan Antonio Fernández-Lozano
BACKGROUND: The GRACE (Global Registry of Acute Coronary Events) risk score is recommended for risk stratification in acute coronary syndrome (ACS). It does not include sex, a variable strongly associated with ACS prognosis. The aim of this study was to examine if sex adds prognostic information to the GRACE score in a contemporary population. MATERIALS AND METHODS: Analysis of discrimination and calibration of GRACE score in the validation population, derived from the ARIAM-SEMICYUC registry (2012-2015)...
January 20, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28106147/prediction-of-very-late-arrhythmia-recurrence-after-radiofrequency-catheter-ablation-of-atrial-fibrillation-the-mb-later-clinical-score
#3
Nebojša Mujović, Milan Marinković, Nebojša Marković, Alena Shantsila, Gregory Y H Lip, Tatjana S Potpara
Reliable prediction of very late recurrence of atrial fibrillation (VLRAF) occuring >12 months after catheter ablation (CA) in apparently "cured" patients could optimize long-term follow-up and modify decision-making regarding the discontinuation of oral anticoagulant therapy. In a single-centre cohort of consecutive patients post radiofrequency AFCA, we retrospectively derived a novel score for VLRAF prediction. Of 133 consecutive post AFCA patients (mean age 56.9 ± 11.8 years, 63.9% male, 69.2% with paroxysmal AF) who were arrhythmia-free at 12 months (excluding 3-month "blanking period"), 20 patients expirienced a VLRAF during a 29...
January 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28101856/relationship-of-long-term-prognosis-to-mmp-and-timp-polymorphisms-in-patients-after-st-elevation-myocardial-infarction
#4
Monika Pavkova Goldbergova, Jiri Jarkovsky, Jolana Lipkova, Simona Littnerova, Martin Poloczek, Jindrich Spinar, Lenka Kubkova, Krystyna Kluz, Petr Kala, Jan Manousek, Anna Vasku, Jiri Parenica
The influence of polymorphisms in the large group of MMP and TIMP genes on clinical outcomes in patients after ST elevation myocardial infarction (STEMI) treated with primary PCI was analysed. In total, 550 consecutive Caucasian patients with STEMI were included in the present study, with a median of 32 months. We analysed 19 polymorphisms in the genes coding MMP and TIMP genes. The MMP-1 -519A/G and -422A/T polymorphisms are associated with combined endpoint after myocardial infarction. The hazard ratio for AT variant of MMP-1 -422A/T was 1...
January 18, 2017: Journal of Applied Genetics
https://www.readbyqxmd.com/read/28099585/impact-of-different-normality-thresholds-for-24-hour-abpm-at-the-primary-health-care-level
#5
Guilherme Brasil Grezzana, David William Moraes, Airton Tetelbon Stein, Lucia Campos Pellanda
Background: Hypertension is an important risk factor for cardiovascular outcomes. Primary health care (PHC) physicians should be prepared to act appropriately in the prevention of cardiovascular risk factors. However, the rates of patients with control of blood pressure (BP) remain low. The impact of the reclassification of high BP by 24-hour ambulatory BP monitoring (ABPM) can lead to different medical decisions in PHC. Objective: To evaluate the agreement between the BP measured by a conventional method by PHC physicians and by 24-hour ABPM, considering different BP normal thresholds for the 24-hour ABPM according to the V Brazilian ABPM Guidelines and the European Society of Hypertension Guidelines...
January 16, 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28087832/comparison-of-cardiovascular-risk-algorithms-in-patients-with-vs-without-rheumatoid-arthritis-and-the-role-of-c-reactive-protein-in-predicting-cardiovascular-outcomes-in-rheumatoid-arthritis
#6
Evo Alemao, Hélène Cawston, François Bourhis, Maiwenn Al, Maureen Rutten-van Molken, Katherine P Liao, Daniel H Solomon
OBJECTIVES: The aims were to compare the performance of cardiovascular risk calculators, Framingham Risk Score (FRS) and QRISK2, in RA and matched non-RA patients and to evaluate whether their performance could be enhanced by the addition of CRP. METHODS: We conducted a retrospective analysis, using a clinical practice data set linked to Hospital Episode Statistics (HES) data from the UK. Patients presenting with at least one RA diagnosis code and no prior cardiovascular events were matched to non-RA patients using disease risk scores...
January 12, 2017: Rheumatology
https://www.readbyqxmd.com/read/28087176/carotid-plaque-detection-improves-the-predictive-value-of-cha2ds2-vasc-score-in-patients-with-non-valvular-atrial-fibrillation-the-arapacis-study
#7
Stefania Basili, Lorenzo Loffredo, Daniele Pastori, Marco Proietti, Alessio Farcomeni, Anna Rita Vestri, Pasquale Pignatelli, Giovanni Davì, William R Hiatt, Gregory Y H Lip, Gino R Corazza, Francesco Perticone, Francesco Violi
BACKGROUND AND AIMS: Vascular disease (VD), as assessed by history of myocardial infarction or peripheral artery disease or aortic plaque, increases stroke risk in atrial fibrillation (AF), and is a component of risk assessment using the CHA2DS2-VASc score. We investigated if systemic atherosclerosis as detected by ultrasound carotid plaque (CP) could improve the predictive value of the CHA2DS2-VASc score. METHODS: We analysed data from the ARAPACIS study, an observational study including 2027 Italian patients with non-valvular AF, in whom CP was detected using Doppler Ultrasonography...
January 4, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28078828/biomarkers-upon-discontinuation-of-renal-replacement-therapy-predict-60-day-survival-and-renal-recovery-in-critically-ill-patients-with-acute-kidney-injury
#8
Tingting Yang, Si Sun, Yuliang Zhao, Qiang Liu, Mei Han, Liping Lin, Baihai Su, Songmin Huang, Lichuan Yang
Introduction There is no consensus on the specific indications for weaning critically ill patients with acute kidney injury (AKI) off renal replacement therapy (RRT). This study aimed to explore the prognostic value of several biomarkers measured upon discontinuation of RRT for their value in predicting 60-day survival and renal recovery in an effort to add knowledge to the decision-making process regarding RRT withdrawal. Methods We prospectively enrolled 102 patients with AKI who required RRT from the intensive care unit...
January 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28075034/abdominal-lean-muscle-is-associated-with-lower-mortality-among-kidney-waitlist-candidates
#9
Jayme E Locke, J Jeff Carr, Sangeeta Nair, James G Terry, Rhiannon D Reed, Grant D Smith, Dorry L Segev, Vineeta Kumar, Cora E Lewis
Morphometric assessments, such as muscle density and body fat distribution, have emerged as strong predictors of cardiovascular risk and post-operative morbidity and mortality. To date, no study has examined morphometric mortality risk prediction among kidney transplant (KT) candidates. KT candidates, waitlisted 2008-2009 were identified (n=96) and followed to the earliest of transplant, death, or administrative end of study. Morphometric measures, including abdominal adipose tissue, paraspinous and psoas muscle composition, and aortic calcification were measured from CTs...
January 11, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28065681/mid-regional-pro-adrenomedullin-in-patients-with-acute-dyspnea-data-from-the-akershus-cardiac-examination-ace-2-study
#10
Mohammad Osman Pervez, Magnus Nakrem Lyngbakken, Peder Langeland Myhre, Jon Brynildsen, Eva Camilla Langsjøen, Arne Didrik Høiseth, Geir Christensen, Torbjørn Omland, Helge Røsjø
BACKGROUND: Mid-regional pro-adrenomedullin (MR-proADM) is a surrogate marker for adrenomedullin; a hormone that attenuates myocardial remodeling. Accordingly, we hypothesized that MR-proADM could provide diagnostic and prognostic information in patients with acute dyspnea. METHODS AND RESULTS: We measured MR-proADM by a commercial ELISA on hospital admission in 311 patients with acute dyspnea and compared the utility of MR-proADM with N-terminal pro-B-type natriuretic peptide (NT-proBNP)...
January 5, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28065488/utility-of-normal-findings-on-electrocardiogram-and-echocardiogram-in-subjects-%C3%A2-65%C3%A2-years
#11
Sanjay Venkatesh, Wesley T O'Neal, Stephen T Broughton, Amit J Shah, Elsayed Z Soliman
The lack of abnormalities found on noninvasive cardiac testing possibly improves cardiovascular disease (CVD) risk stratification efforts and conveys reduced risk despite the presence of traditional risk factors. This analysis included 3,805 (95% white and 61% women) participants from the Cardiovascular Health Study (CHS) without baseline CVD. The combination of a normal electrocardiogram (ECG) and echocardiogram was assessed for the development of CVD. A normal ECG was defined as the absence of major or minor Minnesota code abnormalities...
December 18, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/28062677/filtration-markers-as-predictors-of-esrd-and-mortality-individual-participant-data-meta-analysis
#12
Lesley A Inker, Josef Coresh, Yingying Sang, Chi-Yuan Hsu, Meredith C Foster, John H Eckfeldt, Amy B Karger, Robert G Nelson, Xun Liu, Mark Sarnak, Lawrence J Appel, Morgan Grams, Dawei Xie, Paul L Kimmel, Harold Feldman, Vasan Ramachandran, Andrew S Levey
BACKGROUND AND OBJECTIVES: Serum β-trace protein (BTP) and β-2 microglobulin (B2M) are associated with risk of ESRD and death in the general population and in populations at high risk for these outcomes (GP/HR) and those with CKD, but results differ among studies. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We performed an individual patient-level meta-analysis including three GP/HR studies (n=17,903 participants) and three CKD studies (n=5415). We compared associations, risk prediction, and improvement in reclassification of eGFR using BTP (eGFRBTP) and B2M (eGFRB2M) alone and the average (eGFRavg) of eGFRBTP, eGFRB2M, creatinine (eGFRcr), and cystatin C (eGFRcys), to eGFRcr, eGFRcys, and their combination (eGFRcr-cys) for ESRD (2075 events) and death (7275 events)...
January 6, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28062624/plasma-n-terminal-prosomatostatin-and-risk-of-incident-cardiovascular-disease-and-all-cause-mortality-in-a-prospective-observational-cohort-the-prevend-study
#13
Ali Abbasi, Lyanne M Kieneker, Eva Corpeleijn, Ron T Gansevoort, Rijk O B Gans, Joachim Struck, Rudolf A de Boer, Hans L Hillege, Ronald P Stolk, Gerjan Navis, Stephan J L Bakker
BACKGROUND: Somatostatin is a component of the well-known insulin-like growth factor-1/growth hormone (GH) longevity axis. There is observational evidence that increased GH is associated with an increased risk of cardiovascular disease (CVD). We aimed to investigate the potential association of plasma N-terminal fragment prosomatostatin (NT-proSST) with incident CVD and all-cause mortality in apparently healthy adults. METHODS: We studied 8134 participants without history of CVD (aged 28-75 years; women, 52...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28058053/survival-regression-modeling-strategies-in-cvd-prediction
#14
Mahnaz Barkhordari, Mojgan Padyab, Mahsa Sardarinia, Farzad Hadaegh, Fereidoun Azizi, Mohammadreza Bozorgmanesh
BACKGROUND: A fundamental part of prevention is prediction. Potential predictors are the sine qua non of prediction models. However, whether incorporating novel predictors to prediction models could be directly translated to added predictive value remains an area of dispute. The difference between the predictive power of a predictive model with (enhanced model) and without (baseline model) a certain predictor is generally regarded as an indicator of the predictive value added by that predictor...
April 2016: International Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28055992/-practicality-of-cardiovascular-risk-functions
#15
Jaume Marrugat, Roberto Elosua, Gloria Icaza, Alberto Morales-Salinas, Irene R Dégano
Cardiovascular diseases prevention strategies require refinement because their incidence decreases very slowly. Risk functions were developed by including classical cardiovascular risk factors (age, sex, smoking, diabetes, blood pressure, and basic lipid profile) in cohorts followed more than 10 years. They are reasonably precise for population screening of, principally, coronary artery disease risk, required in all cardiovascular primary prevention clinical guidelines. Coronary artery disease risk functions classify patients in risk strata to concentrate the maximum therapeutic and life style effort in the highest risk groups, in which the number needed to treat and cost-effectiveness are optimal...
December 13, 2016: Medwave
https://www.readbyqxmd.com/read/28052940/endometrial-cancer-risk-factors-hormone-receptors-and-mortality-prediction
#16
Evan L Busch, Marta Crous-Bou, Jennifer Prescott, Maxine M Chen, Michael J Downing, Bernard Rosner, George L Mutter, Immaculata De Vivo
BACKGROUND: Endometrial tumors arise from a hormonally-responsive tissue. Defining subtypes by hormone receptors might better inform etiology and prediction of patient outcomes. We evaluated the potential role of tumor estrogen receptor (ER) and progesterone receptor (PR) expression to define endometrial cancer subtypes. METHODS: We measured semi-continuous ER and PR protein expression in tissue specimens from 360 endometrial primary tumors from the Nurses' Health Study...
January 4, 2017: Cancer Epidemiology, Biomarkers & Prevention
https://www.readbyqxmd.com/read/28050887/assessment-of-in-silico-protein-sequence-analysis-in-the-clinical-classification-of-variants-in-cancer-risk-genes
#17
Iain D Kerr, Hannah C Cox, Kelsey Moyes, Brent Evans, Brianna C Burdett, Aric van Kan, Heather McElroy, Paris J Vail, Krystal L Brown, Dechie B Sumampong, Nicholas J Monteferrante, Kennedy L Hardman, Aaron Theisen, Erin Mundt, Richard J Wenstrup, Julie M Eggington
Missense variants represent a significant proportion of variants identified in clinical genetic testing. In the absence of strong clinical or functional evidence, the American College of Medical Genetics recommends that these findings be classified as variants of uncertain significance (VUS). VUSs may be reclassified to better inform patient care when new evidence is available. It is critical that the methods used for reclassification are robust in order to prevent inappropriate medical management strategies and unnecessary, life-altering surgeries...
January 3, 2017: Journal of Community Genetics
https://www.readbyqxmd.com/read/28050863/incremental-prognostic-value-of-spect-mpi-in-chronic-kidney-disease-a-reclassification-analysis
#18
Amjad M Ahmed, Waqas T Qureshi, Wesley T O'Neal, Fatima Khalid, Mouaz H Al-Mallah
BACKGROUND: Traditional cardiovascular (CV) risk factors have limited predictive value of CV mortality in patients with chronic kidney disease (CKD, creatinine clearance less than 60 mL/minute per 1.73 m(2)). The aim of this study was to evaluate incremental and independent prognostic value of single-photon emission computerized tomography-myocardial perfusion imaging (SPECT-MPI) across continuum of renal function. METHODS: We retrospectively studied 11,518 (mean age, 65 ± 12 years; 52% were men) patients referred for a clinical indication of SPECT-MPI between April 2004 and May 2009...
January 3, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28049363/circulating-chromogranin-b-levels-in-patients-with-acute-respiratory-failure-data-from-the-finnali-study
#19
Peder Langeland Myhre, Mats Stridsberg, Rita Linko, Marjatta Okkonen, Ståle Nygård, Geir Christensen, Ville Pettilä, Torbjørn Omland, Helge Røsjø
PURPOSE: Circulating chromogranin B (CgB) levels are increased in situations characterized by systemic and myocardial stress, but whether CgB provides prognostic information in patients with acute respiratory failure (ARF) is unknown. METHODS: We included 584 patients with ARF, defined as ventilatory support >6 h, and with blood samples available on Intensive Care Unit (ICU) admission and day 3 (n = 479). CgB levels were measured by radioimmunoassay and follow-up was 90 days...
January 3, 2017: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
https://www.readbyqxmd.com/read/28041714/comparison-of-prognostic-risk-scores-after-successful-primary-percutaneous-coronary-intervention
#20
Andreas Synetos, George Georgiopoulos, Voula Pylarinou, Konstantinos Toutouzas, Katerina Maniou, Maria Drakopoulou, Panagiotis Tolis, Antonios Karanasos, Aggelos Papanikolaou, George Latsios, Eleftherios Tsiamis, Dimitrios Tousoulis
BACKGROUND: The aim of this study was to compare the predictive ability of clinical risk scores (ACEF, EuroSCORE and EuroSCORE II) to angiographic (SYNTAX score) and combined risk scores (Global Risk Score and Clinical SXscore) towards cardiovascular death and/or major adverse cardiac events (MACE) in patients with ST-segment elevation acute myocardial infarction (STEMI) managed with primary percutaneous coronary intervention (pPCI). METHODS: A total of 685 patients successfully treated with pPCI were evaluated and the risk scores were calculated...
December 24, 2016: International Journal of Cardiology
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