Including measures of chronic kidney disease to improve cardiovascular risk prediction by SCORE2 and SCORE2-OP

DOI PDF PDF 16 References
  • Kunihiro Matsushita
    Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health , Baltimore, MD , USA
  • Stephen Kaptoge
    Department of Public Health and Primary Care, University of Cambridge , Cambridge , United Kingdom
  • Steven H J Hageman
    Department of Vascular Medicine, University Medical Center Utrecht , Utrecht , The Netherlands
  • Yingying Sang
    Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health , Baltimore, MD , USA
  • Shoshana H Ballew
    Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health , Baltimore, MD , USA
  • Morgan E Grams
    Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health , Baltimore, MD , USA
  • Aditya Surapaneni
    Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health , Baltimore, MD , USA
  • Luanluan Sun
    Department of Public Health and Primary Care, University of Cambridge , Cambridge , United Kingdom
  • Johan Arnlov
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet , Stockholm , Sweden
  • Milica Bozic
    Vascular & Renal Translational Research Group, IRBLleida, Spain and Spanish Research Network for Renal Diseases (RedInRen. ISCIII) , Lleida , Spain
  • Hermann Brenner
    Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ) and Network Aging Research, University of Heidelberg , Heidelberg , Germany
  • Nigel J Brunskill
    John Walls Renal Unit, Department of Cardiovascular Sciences, Leicester General Hospital, University Hospitals of Leicester NHS Trust, University of Leicester , Leicester , United Kingdom
  • Alex R Chang
    Department of Nephrology and Kidney Health Research Institute, Geisinger Medical Center , Danville, Pennsylvania
  • Rajkumar Chinnadurai
    Department of Renal Medicine, Salford Care Organisation, Northern Care Alliance NHS Foundation Trust , Salford , UK
  • Massimo Cirillo
    Department of Public Health, University of Naples ‘Federico II’ , Italy
  • Adolfo Correa
    University of Mississippi Medical Center , Jackson, MS , USA
  • Natalie Ebert
    Institute of Public Health, Charité—Universitätsmedizin Berlin , Berlin , Germany
  • Kai-Uwe Eckardt
    Department of Nephrology and Hypertension, Friedrich-Alexander Universität Erlangen-Nürnberg , Erlangen , Germany
  • Ron T Gansevoort
    Department of Nephrology, University Medical Center Groningen, University of Groningen , Groningen , the Netherlands
  • Orlando Gutierrez
    Departments of Epidemiology and Medicine, University of Alabama at Birmingham , Birmingham, AL , USA
  • Farzad Hadaegh
    Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences , Tehran , Iran
  • Jiang He
    Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine , New Orleans, LA , USA
  • Shih-Jen Hwang
    National Heart, Lung, and Blood Institute , Framingham, MA , USA
  • Tazeen H Jafar
    Program in Health Services and Systems Research, Duke-National University of Singapore Medical School , Singapore
  • Simerjot K Jassal
    Division of General Internal Medicine, University of California, San Diego and VA San Diego Healthcare , San Diego, CA
  • Takamasa Kayama
    Global Center of Excellence, Yamagata University Faculty of Medicine , Yamagata , Japan
  • Csaba P Kovesdy
    Medicine-Nephrology, Memphis Veterans Affairs Medical Center and University of Tennessee Health Science Center , Memphis, TN , USA
  • Gijs W Landman
    Gelre hospital location , Apeldoorn , The Netherlands
  • Andrew S Levey
    Division of Nephrology, Tufts Medical Center , Boston, MA , USA
  • Donald M Lloyd-Jones
    Department of Preventive Medicine, Northwestern University , Chicago, IL , USA
  • Rupert W Major
    John Walls Renal Unit, Department of Cardiovascular Sciences, Leicester General Hospital, University Hospitals of Leicester NHS Trust, University of Leicester , Leicester , United Kingdom
  • Katsuyuki Miura
    NCD Epidemiology Research Center, Shiga University of Medical Science , Shiga , Japan
  • Paul Muntner
    Department of Epidemiology, University of Alabama at Birmingham , Birmingham, AL , USA
  • Girish N Nadkarni
    Department of Medicine, Division of Nephrology, Icahn School of Medicine at Mount Sinai , New York, NY , USA
  • Christoph Nowak
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet , Stockholm , Sweden
  • Takayoshi Ohkubo
    Department of Hygiene and Public Health, Teikyo University School of Medicine , Tokyo , Japan
  • Michelle J Pena
    Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands
  • Kevan R Polkinghorne
    Monash University , Clayton , Australia
  • Toshimi Sairenchi
    Medical Science of Nursing, Dokkyo Medical University School of Nursing , Mibu , Japan
  • Elke Schaeffner
    Institute of Public Health, Charité—Universitätsmedizin Berlin , Berlin , Germany
  • Markus P Schneider
    Department of Nephrology and Hypertension, Friedrich-Alexander Universität Erlangen-Nürnberg , Erlangen , Germany
  • Varda Shalev
    Institute for Health and Research and Innovation, Maccabi Healthcare Services and Tel Aviv University , Tel Aviv , Israel
  • Michael G Shlipak
    Kidney Health Research Collaborative, University of California, San Francisco, and San Francisco VA Healthcare System , San Francisco, CA , USA
  • Marit D Solbu
    Section of Nephrology, University Hospital of North Norway, Norway and UiT The Arctic University of Norway , Tromsø , Norway
  • Nikita Stempniewicz
    AMGA (American Medical Group Association), Virginia and OptumLabs Visiting Fellow , Alexandria, VA , USA
  • James Tollitt
    Department of Renal Medicine, Salford Care Organisation, Northern Care Alliance NHS Foundation Trust , Salford , UK
  • José M Valdivielso
    Vascular & Renal Translational Research Group, IRBLleida, Spain and Spanish Research Network for Renal Diseases (RedInRen. ISCIII) , Lleida , Spain
  • Joep van der Leeuw
    Department of Vascular Medicine, University Medical Center Utrecht , Utrecht , The Netherlands
  • Angela Yee-Moon Wang
    Department of Medicine, Queen Mary Hospital, The University of Hong Kong , Hong Kong
  • Chi-Pang Wen
    China Medical University Hospital , Taichung , Taiwan
  • Mark Woodward
    Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health , Baltimore, MD , USA
  • Kazumasa Yamagishi
    Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba , Japan
  • Hiroshi Yatsuya
    Department of Public Health, Fujita Health University School of Medicine, Japan and Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine , Aichi , Japan
  • Luxia Zhang
    Peking University First Hospital and Peking University , Beijing , China
  • Jannick A N Dorresteijn
    Department of Vascular Medicine, University Medical Center Utrecht , Utrecht , The Netherlands
  • Emanuele Di Angelantonio
    Department of Public Health and Primary Care, University of Cambridge , Cambridge , United Kingdom
  • Frank L J Visseren
    Department of Vascular Medicine, University Medical Center Utrecht , Utrecht , The Netherlands
  • Lisa Pennells
    Department of Public Health and Primary Care, University of Cambridge , Cambridge , United Kingdom
  • Josef Coresh
    Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health , Baltimore, MD , USA

Description

<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Aims</jats:title> <jats:p>The 2021 European Society of Cardiology (ESC) guideline on cardiovascular disease (CVD) prevention categorizes moderate and severe chronic kidney disease (CKD) as high and very-high CVD risk status regardless of other factors like age and does not include estimated glomerular filtration rate (eGFR) and albuminuria in its algorithms, systemic coronary risk estimation 2 (SCORE2) and systemic coronary risk estimation 2 in older persons (SCORE2-OP), to predict CVD risk. We developed and validated an ‘Add-on’ to incorporate CKD measures into these algorithms, using a validated approach.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>In 3,054 840 participants from 34 datasets, we developed three Add-ons [eGFR only, eGFR + urinary albumin-to-creatinine ratio (ACR) (the primary Add-on), and eGFR + dipstick proteinuria] for SCORE2 and SCORE2-OP. We validated C-statistics and net reclassification improvement (NRI), accounting for competing risk of non-CVD death, in 5,997 719 participants from 34 different datasets.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>In the target population of SCORE2 and SCORE2-OP without diabetes, the CKD Add-on (eGFR only) and CKD Add-on (eGFR + ACR) improved C-statistic by 0.006 (95%CI 0.004–0.008) and 0.016 (0.010–0.023), respectively, for SCORE2 and 0.012 (0.009–0.015) and 0.024 (0.014–0.035), respectively, for SCORE2-OP. Similar results were seen when we included individuals with diabetes and tested the CKD Add-on (eGFR + dipstick). In 57 485 European participants with CKD, SCORE2 or SCORE2-OP with a CKD Add-on showed a significant NRI [e.g. 0.100 (0.062–0.138) for SCORE2] compared to the qualitative approach in the ESC guideline.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>Our Add-ons with CKD measures improved CVD risk prediction beyond SCORE2 and SCORE2-OP. This approach will help clinicians and patients with CKD refine risk prediction and further personalize preventive therapies for CVD.</jats:p> </jats:sec>

Journal

References(16)*help

See more

Related Projects

See more

Report a problem

Back to top