Arterial Disease Risk Score Predicts Cardiovascular Events

A new study describes a prediction model to aid doctors in more accurately determining the risk cardiovascular disease (CVD) patients face for developing a new event.

Researchers at University Medical Center (UMC; Utrecht, The Netherlands), Erasmus Medical Center (Rotterdam, The Netherlandsl), and other institutions, conducted a study involving 5,788 patients referred with various clinical manifestations of arterial disease between January 1996 and February 2010. The data were used for the development and validation of stratification and prediction models of recurrent event risk based on vascular risk factors, imaging, or both. In all, 788 recurrent vascular events—such as myocardial infarction (MI), stroke, or vascular death—were observed during a mean 4.7 years of follow-up.

The end result was a Secondary Manifestations of ARTerial disease (SMART) model for prediction of 10-year recurrent vascular event risk, based on age and sex, in addition to clinical parameters that included medical history, current smoking, systolic blood pressure, and laboratory biomarkers. By using the clinical parameters alone model—without imaging or ultrasound data—there was less than 20% risk in 59% of patients, 20%–30% risk in 19%, and over 30% risk in 23%. The study was published online first on April 10, 2013, in Heart.


“Up to now, we put all patients with vascular disease in one and the same high-risk group, even if we knew from daily practice that there is an enormous variation in the risk between patients,” said study coauthor Prof. Frank Visseren, MD, a UMC specialist in internal and vascular medicine. “Some patients have a high risk while many others have only a low or normal risk of a recurring cardiovascular event; but until recently we were not able to differentiate between them. By using the SMART risk score that is now possible, which means that we can give better treatment advice to patients.”

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University Medical Center
Erasmus Medical Center