Most Read Articles
Pearl Toh, 10 Oct 2019
Adding a LAMA* to the double combination therapy of ICS** plus LABA*** in a single inhaler improves lung function and reduces exacerbations in patients whose asthma is inadequately controlled with the combination treatment, according to the TRIMARAN and TRIGGER# studies presented at ERS 2019.
4 days ago
Eating alone may help in weight management as findings of a recent study suggest that eating with friends lead to higher food intake.
Tristan Manalac, 3 days ago
A digital-first approach, iConnect, allows patients to have greater access to services and guidance and enables healthcare providers to deliver much better postdischarge care, according to Lim Cher Wee, chief operating officer of the Ministry of Health, Office for Healthcare Transformation of Singapore, in his presentation at the recently concluded AsiaPac19 Conference & Exhibition of the Healthcare Information and Management Systems Society (HIMSS 2019).
Jairia Dela Cruz, 3 days ago
Toileting behaviours such as convenience and delayed voiding, straining to void, and position preference are strongly associated with overactive bladder (OAB) symptoms in women, according to a study.

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.”

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Most Read Articles
Pearl Toh, 10 Oct 2019
Adding a LAMA* to the double combination therapy of ICS** plus LABA*** in a single inhaler improves lung function and reduces exacerbations in patients whose asthma is inadequately controlled with the combination treatment, according to the TRIMARAN and TRIGGER# studies presented at ERS 2019.
4 days ago
Eating alone may help in weight management as findings of a recent study suggest that eating with friends lead to higher food intake.
Tristan Manalac, 3 days ago
A digital-first approach, iConnect, allows patients to have greater access to services and guidance and enables healthcare providers to deliver much better postdischarge care, according to Lim Cher Wee, chief operating officer of the Ministry of Health, Office for Healthcare Transformation of Singapore, in his presentation at the recently concluded AsiaPac19 Conference & Exhibition of the Healthcare Information and Management Systems Society (HIMSS 2019).
Jairia Dela Cruz, 3 days ago
Toileting behaviours such as convenience and delayed voiding, straining to void, and position preference are strongly associated with overactive bladder (OAB) symptoms in women, according to a study.