Most Read Articles
5 days ago
The consumption of red and processed meats does not seem to affect the likelihood of symptom relapse among Crohn’s disease (CD) patients in relapse, reports a recent study.
Pearl Toh, 2 days ago
In addition to the known evils of maternal smoking during pregnancy on the son’s semen quality, prenatal exposure to paternal smoking can also be harmful, according to data from a large Danish National Birth Cohort (DNBC) presented at the ESHRE 2019 Meeting.
5 days ago
Treatment with metformin may improve whole-body and peripheral insulin resistance (IR) in youth who are overweight/obese with type 1 diabetes (T1D), according to a study.
2 days ago
Fluticasone, swallowed from a multidose inhaler, and oral viscous budesonide slurry have comparable efficacies as initial treatment for eosinophilic oesophagitis, a recent study has found.

Low CAC, galectin-3 tied to low cardiovascular risk in elderly adults

09 Jul 2019

Among elderly adults, those with coronary artery calcium (CAC)=0, CAC ≤10, low galectin-3 or no carotid plaque have significantly low cardiovascular risk, a study has shown. This calls into question the suitability of a treat-all approach in this population.

The strongest negative risk markers were CAC=0 and CAC ≤10, with mean diagnostic likelihood ratios (DLRs) of 0.20 and 0.20 for coronary heart disease (ie, 80-percent lower risk than expected from traditional risk factor assessment) and 0.41 and 0.48 for cardiovascular disease, respectively. This was followed by galectin-3 <25th percentile (DLR, 0.44 and 0.43, respectively) and absence of carotid plaque (DLR, 0.39 and 0.65, respectively). Other markers obtained less remarkable results.

CAC=0 (net reclassification index [NRI], 0.23) and CAC ≤10 (NRI, 0.28) also showed the largest accurate downward risk reclassification across the class I statin-eligibility threshold defined by the American College of Cardiology/American Heart Association. This was followed by galectin-3 <25th percentile (NRI, 0.14) and absence of carotid plaque (NRI, 0.08).

A total of 13 candidate markers were evaluated in 5,805 BioImage participants (mean age, 69 years; median follow-up, 2.7 years), namely CAC=0, CAC ≤10, no carotid plaque, no family history, normal ankle-brachial index, test result <25th percentile (carotid intima-media thickness, apolipoprotein B, galectin-3, high-sensitivity C-reactive protein, lipoprotein(a), N-terminal pro–B-type natriuretic peptide and transferrin) and apolipoprotein A1 >75th percentile. Patient-specific DLR and binary NRI were used to compare negative marker performance.

“Cardiovascular risk increases dramatically with age, leading to nearly universal risk-based statin eligibility in the elderly population,” the authors said. “To limit overtreatment, elderly individuals at truly low risk need to be identified.”

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Doctor - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
5 days ago
The consumption of red and processed meats does not seem to affect the likelihood of symptom relapse among Crohn’s disease (CD) patients in relapse, reports a recent study.
Pearl Toh, 2 days ago
In addition to the known evils of maternal smoking during pregnancy on the son’s semen quality, prenatal exposure to paternal smoking can also be harmful, according to data from a large Danish National Birth Cohort (DNBC) presented at the ESHRE 2019 Meeting.
5 days ago
Treatment with metformin may improve whole-body and peripheral insulin resistance (IR) in youth who are overweight/obese with type 1 diabetes (T1D), according to a study.
2 days ago
Fluticasone, swallowed from a multidose inhaler, and oral viscous budesonide slurry have comparable efficacies as initial treatment for eosinophilic oesophagitis, a recent study has found.