Projects per year
Abstract
Background: Accurate risk stratification is vital for primary prevention of cardiovascular disease (CVD). However, traditional tools such as the Framingham Risk Score (FRS) may underperform within the diverse intermediate-risk group, which includes individuals requiring distinct management strategies. Objectives: This study aimed to develop a lipidomic-enhanced risk score (LRS), specifically targeting risk prediction and reclassification within the intermediate group, benchmarked against the FRS. Methods: The LRS was developed via a machine learning workflow using ridge regression on the Australian Diabetes, Obesity, and Lifestyle Study (AusDiab; n = 10,339). It was externally validated with the Busselton Health Study (n = 4,492), and its predictive utility for coronary artery calcium scoring (CACS)–based outcomes was independently validated in the BioHEART cohort (n = 994). Results: LRS significantly improved discrimination metrics for the intermediate-risk group in both AusDiab and Busselton Health Study cohorts (all P < 0.001), increasing the area under the curve for CVD events by 0.114 (95% CI: 0.1123-0.1157) and 0.077 (95% CI: 0.0755-0.0785), with a net reclassification improvement of 0.36 (95% CI: 0.21-0.51) and 0.33 (95% CI: 0.15-0.49), respectively. For CACS-based outcomes in BioHEART, LRS achieved a significant area under the curve improvement of 0.02 over the FRS (0.76 vs 0.74; P < 1.0 × 10-5). A simplified, clinically applicable version of LRS was also created that had comparable performance to the original LRS. Conclusions: LRS, augmenting the FRS, presents potential to improve intermediate-risk stratification and to predict atherosclerotic markers using a simple blood test, suitable for clinical application. This could facilitate the triage of individuals for noninvasive imaging such as CACS, fostering precision medicine in CVD prevention and management.
Original language | English |
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Pages (from-to) | 434-446 |
Number of pages | 13 |
Journal | Journal of the American College of Cardiology |
Volume | 84 |
Issue number | 5 |
DOIs | |
Publication status | Published - 30 Jul 2024 |
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Dive into the research topics of 'Lipidomic Risk Score to Enhance Cardiovascular Risk Stratification for Primary Prevention'. Together they form a unique fingerprint.Projects
- 1 Curtailed
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The Busselton Family Heart Study
Moses, E., Meikle, P., Blangero, J., Melton, P., Hung, J., Beilby, J., Cadby, G., Dubé, M. P., Van Bockxmeer, F. & Watts, G.
NHMRC National Health and Medical Research Council
1/01/16 → 9/10/20
Project: Research