![]() Diabetic nephropathy (DN) status was defined by urinary albumin excretion rate (AER) or albumin-to-creatinine ratio (ACR) in two of three timed overnight or 24-h urine collections or in morning spot urine samples for ACR. The model has eight predictors: diabetes duration, onset age of diabetes, total cholesterol-to-HDL cholesterol ratio, HbA 1c, systolic BP, smoking status, macroalbuminuria, and previous CVD ( 11). Furthermore, recent studies have shown similarities between the genetic architecture of CAD in individuals with and without diabetes, also specifically type 1 diabetes, by observing correlated effect estimates on the known loci in genome-wide association studies (GWAS) ( 15, 16, 23).Ī clinical risk score for CAD was calculated based on a validated 5-year CVD risk model in type 1 diabetes ( 11). Moreover, there is evidence from the general population that in those with the highest GRS, lifestyle modification or statin therapy reduce the risk of CAD by ∼50% and are more effective when initiated at the early stages of the disease ( 21, 22). ( 20) reported a large area under curve (AUC) value (0.81) for a genome-wide polygenic risk score (PRS) in CAD prediction. Notably, CAD risk stratification by genetic risk scores (GRSs) has been shown to discriminate high- and low-risk individuals for CAD in the general population ( 18– 20). Of note, although research on type 1 diabetes-specific CAD risk variants has been scarce, there has been evidence for some variants to increase CAD risk only in individuals with type 1 diabetes ( 15– 17). To date, 163 genetic variants have been genome-wide significantly associated with CAD in the general population ( 14). The 2013 ACC/AHA guidelines recommend either a high-intensity or moderate-intensity statin regimen in patients who have an elevated ASCVD risk (≥ 7.5%) for primary prevention of cardiovascular disease.Genetics is also known to contribute to the development of CAD. Compared to Caucasians, the risk of ASCVD is generally lower among Hispanic and Asian populations and generally higher among American-Indian populations. Given the lack of data, current guidelines suggest to use the "Caucasian" race to estimate 10-year ASCVD risk with the knowledge that further research is needed to stratify these patients' risk. There are inadequate data in other racial groups, such as Hispanics, Asians, and American-Indian populations. The Pooled Cohort Equations were developed and validated among Caucasian and African American men and women who did not have clinical ASCVD. Impact of Race on the Pooled Cohort Equations The purpose of the Pooled Cohort Equations is to estimate the risk of ASCVD within a 10-year period among patients who have never had one of these events in the past. Want to nerd out? Check out our interactive ASCVD visualization graphing toolĪSCVD stands for atherosclerotic cardiovascular disease, defined as a nonfatal myocardial infarction (heart attack), coronary heart disease death, or stroke. Individuals without clinical ASCVD or diabetes who are 40 to 75 years of age with LDL 70 to 189 mg/dL and a 10-year ASCVD risk of 7.5% or higherĪs shown above, among patients who do not otherwise have a compelling indication for statin therapy, the Pooled Cohort Equations can be used to estimate primary cardiovascular risk and potential benefit from statin therapy.Individuals 40 to 75 years of age with diabetes and an LDL 70 to 189 mg/dL without clinical ASCVD.Individuals with primary elevations of LDL ≥ 190 mg/dL.3Ĭurrent guidelines for the treatment of cholesterol to reduce cardiovascular risk recommend that the following four groups of patients will benefit from moderate- or high-intensity statin therapy: 2 In many ways, the Pooled Cohort Equations have been proposed to replace the Framingham Risk 10-year CVD calculation, which was recommended for use in the NCEP ATP III guidelines for high blood cholesterol in adults. 1 Patients are considered to be at "elevated" risk if the Pooled Cohort Equations predicted risk is ≥ 7.5%. ![]() This peer-reviewed online calculator uses the Pooled Cohort Equations to estimate the 10-year primary risk of ASCVD (atherosclerotic cardiovascular disease) among patients without pre-existing cardiovascular disease who are between 40 and 79 years of age.
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