Sunnybrook-led research team develops simplified prediction model for cardiovascular disease risk
Current guidelines recommend using models that estimate the risk for atherosclerotic cardiovascular disease (ASCVD) to guide treatment decisions for preventive therapies like cholesterol-lowering statins. A new model developed by clinician-scientists provides a simplified approach that uses only laboratory tests, which may provide a significant advantage over traditional models.
The proposed model and its validation, led by researchers at Sunnybrook Health Sciences Centre, was published in Annals of Internal Medicine.
ASCVD is caused by plaque buildup in arterial walls and refers to conditions including coronary artery disease (such as heart attack or angina) and cerebrovascular disease (such as stroke), among others.
“Current risk models are often underused in clinical practice because they are cumbersome, requiring physicians to collect multiple types of risk factor information such as medical history, physical measurements, and laboratory tests and then input these factors into risk calculators,” says Dr. Dennis Ko, a senior scientist and cardiologist in the Schulich Heart Program at Sunnybrook Health Sciences Centre and one of the lead authors of the study. “A model that uses only laboratory tests and does not rely on clinical variables or physician input may provide a significant advantage over traditional models.”
The research team developed and validated sex-specific models for ASCVD, called CANHEART (Cardiovascular Health in Ambulatory Care Research Team) Lab Models, using age and routine laboratory tests. They compared their performance with the commonly-used risk score pooled cohort equations (PCEs), which require more information and physician input.
The team used an internal validation cohort of more than 3 million men and women to test the CANHEART lab models, measuring serum total cholesterol, high density lipoprotein cholesterol, triglycerides, hemoglobin, mean corpuscular volume, platelets, leukocytes, estimated glomerular filtration rate, and blood glucose – all standard lab tests. The researchers found that the models were well calibrated, with relative differences of less than 1 percent between mean predicted and observed risk for both sexes.
“A risk tool like CANHEART that uses exclusively lab results may facilitate automatic risk reporting in the future and improve the uptake of preventative therapies,” says Dr. Maneesh Sud, lead author of the study and a scientist and cardiologist in the Schulich Heart Program at Sunnybrook. “This will ensure patients are on the right therapies when they need it most.”
Media contact:
Samantha Sexton
Communications Manager, Research
Sunnybrook Health Sciences Centre
samantha.sexton@sunnybrook.ca
