The Concept of CMR
Slides, videos and moreEvaluating CMR
Assessing CVD Risk: Traditional Approaches
Others
- 1Key Points (1 page)
- 2Estimating CHD Risk (1 page)
- 3The SCORE Project (2 pages)
- 4The UKPDS Risk Engine (2 pages)
- 5The Italian CUORE Project (2 pages)
- 6References (1 page)
The Italian CUORE Project
7 of 9
In Italy, CVD is the leading cause of death in adults and accounts for 44% of total deaths (35, 36). Risk prediction models are therefore crucial to estimate CVD risk and identify individuals at high risk of CVD. The CUORE study is a large prospective cohort follow-up study, including cohorts from the Northwest, Northeast, Centre, and South of Italy. The aim of the CUORE project (7) was to develop a 10 year coronary risk predictive equation specific to the Italian population. Among the sample of 6,865 men 35 to 69 years of age and CHD-free at baseline, 312 first fatal and non-fatal major coronary events occurred in the 9.1 year median follow-up. Women were excluded from the analysis because of the small number of events and the shorter follow-up period. The follow-up period is currently being extended and more stable estimates should later be available for women.
The CUORE predictive equation includes well-known CHD risk factors such as age, total cholesterol, systolic blood pressure, cigarette smoking, HDL cholesterol, type 2 diabetes, hypertension medications, and family history of CHD. In the CUORE equation, body mass index (BMI), an index of overall obesity, was not an independent risk factor and did not improve CHD prediction. This could be explained by the fact that other obesity-related risk factors, such as type 2 diabetes, elevated total cholesterol, high blood pressure, and low HDL cholesterol, were already considered in the model. BMI’s impact was thus minor once these risk factors were taken into account. Triglyceride levels were also not included in the model because their inclusion eliminated the protective effect of HDL cholesterol. Once HDL cholesterol was included, adding triglycerides to the model did not improve CHD prediction (37).
7 of 9
