Role of Family History in CAD Risk Assessment

家族史在 CAD 风险评估中的作用

• 批准号: 7139792
• 负责人: MAREN Theresa SCHEUNER
• 金额: $ 19.07万
• 依托单位: RAND CORPORATION
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-07-01 至 2008-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7139792
• 关键词: C reactive protein; antihypercholesterolemic agent; atherosclerosis; cardiovascular disorder chemotherapy; cardiovascular disorder epidemiology; cardiovascular disorder prevention; cardiovascular disorder risk; chemoprevention; clinical research; coronary disorder; cost effectiveness; data collection methodology /evaluation; decision making; diabetes mellitus; family genetics; homocysteine; human data; human middle age (35-64); human old age (65+); hypertension; longitudinal human study; stroke

DESCRIPTION (provided by applicant): Coronary artery disease (CAD) is the leading cause of death and disability in the United States and other industrialized nations. Family history is a significant cardiovascular risk factor that has been underutilized in standard risk assessment methods for CAD and in guidelines for preventive interventions. Using existing data available in the NHLBI-funded Multi-Ethnic Study of Atherosclerosis (MESA) and an existing method for comprehensive familial risk assessment for clinical CAD developed for the Centers for Disease Control and Prevention family history tool, we will develop a familial risk assessment method for subclinical CAD that will assign a level of familial risk (e.g., weak, moderate or strong) to each MESA participant. We will evaluate the ability of this method to stratify an individual's risk for subclinical CAD compared to a standard method that uses other traditional risk factors (i.e., the Framingham Risk Score). We will determine whether traditional or emerging risk factors, such as homocysteine and C-reactive protein, aggregate in individuals with increased familial risk, and we will describe the impact of familial risk assessment for subclinical CAD on current guidelines for lipid-lowering treatment. These results may inform clinical decision-making regarding the role of family history in overall risk assessment for CAD, and the role of increased familial risk as an indication for screening for subclinical CAD or testing for emerging cardiovascular risk factors. In addition, the incremental value of comprehensive familial risk assessment in decision-making regarding lipid-lowering treatment with diet or drugs for primary prevention of CAD will be analyzed.

描述（由申请人提供）：冠状动脉疾病（CAD）是美国和其他工业化国家死亡和残疾的主要原因。家族史是一个重要的心血管危险因素，但在 CAD 标准风险评估方法和预防干预指南中尚未得到充分利用。利用 NHLBI 资助的动脉粥样硬化多种族研究 (MESA) 中的现有数据以及为疾病控制和预防中心家族史工具开发的临床 CAD 综合家族风险评估的现有方法，我们将开发家族风险评估亚临床 CAD 的方法，将为每个 MESA 参与者分配一个家族风险级别（例如，弱、中或强）。与使用其他传统风险因素（即弗雷明汉风险评分）的标准方法相比，我们将评估该方法对个体亚临床 CAD 风险进行分层的能力。我们将确定传统或新出现的危险因素（例如同型半胱氨酸和 C 反应蛋白）是否在家族风险增加的个体中聚集，并且我们将描述亚临床 CAD 家族风险评估对当前降脂治疗指南的影响。这些结果可以为临床决策提供信息，包括家族史在 CAD 总体风险评估中的作用，以及家族风险增加作为亚临床 CAD 筛查或新出现的心血管危险因素检测指标的作用。此外，还将分析综合家族风险评估对于通过饮食或药物降脂治疗进行冠心病一级预防决策的增量价值。