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Novel Prediction Equations for Absolute Risk Assessment of Total Cardiovascular Disease Incorporating Cardiovascular-Kidney-Metabolic Health: A Scientific Statement From the American Heart Association.

Publication ,  Journal Article
Khan, SS; Coresh, J; Pencina, MJ; Ndumele, CE; Rangaswami, J; Chow, SL; Palaniappan, LP; Sperling, LS; Virani, SS; Ho, JE; Neeland, IJ ...
Published in: Circulation
December 12, 2023

Cardiovascular-kidney-metabolic (CKM) syndrome is a novel construct recently defined by the American Heart Association in response to the high prevalence of metabolic and kidney disease. Epidemiological data demonstrate higher absolute risk of both atherosclerotic cardiovascular disease (CVD) and heart failure as an individual progresses from CKM stage 0 to stage 3, but optimal strategies for risk assessment need to be refined. Absolute risk assessment with the goal to match type and intensity of interventions with predicted risk and expected treatment benefit remains the cornerstone of primary prevention. Given the growing number of therapies in our armamentarium that simultaneously address all 3 CKM axes, novel risk prediction equations are needed that incorporate predictors and outcomes relevant to the CKM context. This should also include social determinants of health, which are key upstream drivers of CVD, to more equitably estimate and address risk. This scientific statement summarizes the background, rationale, and clinical implications for the newly developed sex-specific, race-free risk equations: PREVENT (AHA Predicting Risk of CVD Events). The PREVENT equations enable 10- and 30-year risk estimates for total CVD (composite of atherosclerotic CVD and heart failure), include estimated glomerular filtration rate as a predictor, and adjust for competing risk of non-CVD death among adults 30 to 79 years of age. Additional models accommodate enhanced predictive utility with the addition of CKM factors when clinically indicated for measurement (urine albumin-to-creatinine ratio and hemoglobin A1c) or social determinants of health (social deprivation index) when available. Approaches to implement risk-based prevention using PREVENT across various settings are discussed.

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Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

December 12, 2023

Volume

148

Issue

24

Start / End Page

1982 / 2004

Location

United States

Related Subject Headings

  • United States
  • Risk Factors
  • Risk Assessment
  • Male
  • Kidney
  • Humans
  • Heart Failure
  • Female
  • Cardiovascular System & Hematology
  • Cardiovascular Diseases
 

Citation

APA
Chicago
ICMJE
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Khan, S. S., Coresh, J., Pencina, M. J., Ndumele, C. E., Rangaswami, J., Chow, S. L., … American Heart Association, . (2023). Novel Prediction Equations for Absolute Risk Assessment of Total Cardiovascular Disease Incorporating Cardiovascular-Kidney-Metabolic Health: A Scientific Statement From the American Heart Association. Circulation, 148(24), 1982–2004. https://doi.org/10.1161/CIR.0000000000001191
Khan, Sadiya S., Josef Coresh, Michael J. Pencina, Chiadi E. Ndumele, Janani Rangaswami, Sheryl L. Chow, Latha P. Palaniappan, et al. “Novel Prediction Equations for Absolute Risk Assessment of Total Cardiovascular Disease Incorporating Cardiovascular-Kidney-Metabolic Health: A Scientific Statement From the American Heart Association.Circulation 148, no. 24 (December 12, 2023): 1982–2004. https://doi.org/10.1161/CIR.0000000000001191.
Khan SS, Coresh J, Pencina MJ, Ndumele CE, Rangaswami J, Chow SL, Palaniappan LP, Sperling LS, Virani SS, Ho JE, Neeland IJ, Tuttle KR, Rajgopal Singh R, Elkind MSV, Lloyd-Jones DM, American Heart Association. Novel Prediction Equations for Absolute Risk Assessment of Total Cardiovascular Disease Incorporating Cardiovascular-Kidney-Metabolic Health: A Scientific Statement From the American Heart Association. Circulation. 2023 Dec 12;148(24):1982–2004.

Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

December 12, 2023

Volume

148

Issue

24

Start / End Page

1982 / 2004

Location

United States

Related Subject Headings

  • United States
  • Risk Factors
  • Risk Assessment
  • Male
  • Kidney
  • Humans
  • Heart Failure
  • Female
  • Cardiovascular System & Hematology
  • Cardiovascular Diseases