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的死亡和残疾的主要原因。家族病史是一个重要的心血管危险因素，在CAD的标准风险评估方法和预防性干预指南中未充分利用。使用NHLBI资助的动脉粥样硬化多民族研究（MESA）中可用的现有数据，以及一种用于为疾病控制和预防家族史中心开发的全面家庭风险评估方法的现有方法，我们将开发一种家族性风险评估方法的次数cAD，该方法将分配家族风险的水平，例如，弱小的弱点（例如，弱点，弱）。与使用其他传统风险因素（即Framingham风险评分）相比，我们将评估该方法将个人CAD风险分层的能力。我们将确定传统或新兴的危险因素（例如同型半胱氨酸和C反应性蛋白）是否在具有增加家族风险的个体中骨料，我们将描述家庭风险评估对亚临床CAD对当前脂质化力治疗指南的影响。这些结果可能会为临床决策提供有关家族病史在CAD总体风险评估中的作用的临床决策，以及增加家族风险作为筛查亚临床CAD或测试新兴心血管危险因素的作用。此外，将分析有关饮食或药物降低脂质治疗的综合家族风险评估的增量价值，以进行CAD的一级预防。