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| Name | Class |
|---|---|
| Preventive Services and Health Promotion Research Network | OTHER |
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Cardiovascular risk functions fail to identify more than 50% of patients who develop cardiovascular disease. This is especially evident in the intermediate-risk patients in which clinical management becomes difficult. The purpose of this study is to analyze if ankle-brachial index (ABI), measures of arterial stiffness, postprandial glucose, glycosylated hemoglobin, self-measured blood pressure and presence of comorbidity are independently associated to incidence of vascular events and whether they can improve the predictive capacity of current risk equations in the intermediate-risk population.
Primary prevention of cardiovascular diseases is a priority in public health policy of developed and developing countries. The fundamental strategy consists in identifying people in a high risk situation in which preventive measures are effective and efficient. However, specificity and sensitivity of risk equations are modest, which means that approximately 50% of the patients who are likely to develop a vascular event and would benefit from preventive measures are not considered at high risk. While 30% of the subjects considered at risk don't really benefit from preventive measures. Moreover, decisions which imply thousands of people and can determine drug treatment indications are taken every day in primary care centers. These decisions are based mostly on the result of estimations about the probability to develop a vascular disease in 10 years. Improvement of these predictions in our country will have an immediate, clinical and welfare impact and a short term public health effect.
The purpose of this study is to analyze if ankle-brachial index (ABI), measures of arterial stiffness, postprandial glucose, glycosylated hemoglobin, self-measured blood pressure and presence of comorbidity are independently associated to incidence of vascular events and whether they can improve the predictive capacity of current risk equations in the intermediate-risk population.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intermediate risk population | Population aged between 35 to 74 years who have an intermediate cardiovascular risk, defined as coronary risk between 5% -15% at 10 years according to the Framingham adapted risk equation or vascular mortality risk between 3-5% at 10 years according to the SCORE equation [27]. |
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| Measure | Description | Time Frame |
|---|---|---|
| Vascular events | There will be a telephone follow-up at 10 years to verify the vital status and the existence of hospital admissions due to vascular health problems: Fatal and non fatal coronary heart disease (myocardial infarction or angina pectoris), stroke and peripheral arterial disease | 10 years |
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Inclusion Criteria:
Exclusion Criteria:
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Population aged 35 to 74 which have an intermediate cardiovascular risk.
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| Name | Affiliation | Role |
|---|---|---|
| Rafel Ramos | Unidad de Invesitigación en Atención Primaria de Girona, IDIAP Jordi Gol. Instituto de Investigación Biomédica de Girona Dr. Josep Trueta (IDIBGI). Departamento de Ciencias Médicas, Universidad de Girona | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Unidad de Investigación en Atención Primaria de Girona, IDIAP Jordi Gol, Institut Català de la Salut | Girona | 17003 | Spain |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 11975899 | Background | Marrugat J, Elosua R, Marti H. [Epidemiology of ischaemic heart disease in Spain: estimation of the number of cases and trends from 1997 to 2005]. Rev Esp Cardiol. 2002 Apr;55(4):337-46. doi: 10.1016/s0300-8932(02)76611-6. Spanish. | |
| 17726041 | Background | Graham I, Atar D, Borch-Johnsen K, Boysen G, Burell G, Cifkova R, Dallongeville J, De Backer G, Ebrahim S, Gjelsvik B, Herrmann-Lingen C, Hoes A, Humphries S, Knapton M, Perk J, Priori SG, Pyorala K, Reiner Z, Ruilope L, Sans-Menendez S, Scholte op Reimer W, Weissberg P, Wood D, Yarnell J, Zamorano JL, Walma E, Fitzgerald T, Cooney MT, Dudina A; European Society of Cardiology (ESC) Committee for Practice Guidelines (CPG). European guidelines on cardiovascular disease prevention in clinical practice: executive summary: Fourth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (Constituted by representatives of nine societies and by invited experts). Eur Heart J. 2007 Oct;28(19):2375-414. doi: 10.1093/eurheartj/ehm316. Epub 2007 Aug 28. No abstract available. |
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| ID | Term |
|---|---|
| D009203 | Myocardial Infarction |
| D000787 | Angina Pectoris |
| D020521 | Stroke |
| D058729 | Peripheral Arterial Disease |
| ID | Term |
|---|---|
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D014652 | Vascular Diseases |
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Blood sample: Cholesterol and triglycerides concentration, HDL cholesterol, LDL cholesterol, Glucose concentration, glycated hemoglobin and creatinine Urine sample:urine albumin, to calculate the albumin/creatinine index. Postprandial glucose (mg / dl) will be self-measured by patients at home 2 hours after meals (breakfast, lunch and dinner) for one day using an Accu-chek ® glucometer.
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| 35987700 | Derived | Gomez-Sanchez L, Rodriguez-Sanchez E, Ramos R, Marti R, Gomez-Sanchez M, Lugones-Sanchez C, Tamayo-Morales O, Sanchez SG, Rigo F, Garcia-Ortiz L, Gomez-Marcos MA; MARK Investigators. Association of physical activity with vascular aging in a population with intermediate cardiovascular risk, analysis by sex: MARK study. Biol Sex Differ. 2022 Aug 20;13(1):46. doi: 10.1186/s13293-022-00456-w. |
| 30461641 | Derived | Gomez-Marcos MA, Gomez-Sanchez L, Patino-Alonso MC, Recio-Rodriguez JI, Gomez-Sanchez M, Rigo F, Marti R, Agudo-Conde C, Ramos R, Rodriguez-Sanchez E, Maderuelo-Fernandez JA, Garcia-Ortiz L; MARK Group. A body shape index and vascular structure and function in Spanish adults (MARK study): A cross-sectional study. Medicine (Baltimore). 2018 Nov;97(47):e13299. doi: 10.1097/MD.0000000000013299. |
| 28963288 | Derived | Gomez-Sanchez L, Garcia-Ortiz L, Patino-Alonso MC, Recio-Rodriguez JI, Rigo F, Marti R, Agudo-Conde C, Rodriguez-Sanchez E, Maderuelo-Fernandez JA, Ramos R, Gomez-Marcos MA; MARK Group. Adiposity measures and arterial stiffness in primary care: the MARK prospective observational study. BMJ Open. 2017 Sep 27;7(9):e016422. doi: 10.1136/bmjopen-2017-016422. |
| 28414819 | Derived | Gomez-Sanchez L, Garcia-Ortiz L, Patino-Alonso MC, Recio-Rodriguez JI, Feuerbach N, Marti R, Agudo-Conde C, Rodriguez-Sanchez E, Maderuelo-Fernandez JA, Ramos R, Gomez-Marcos MA; MARK Group. Glycemic markers and relation with arterial stiffness in Caucasian subjects of the MARK study. PLoS One. 2017 Apr 17;12(4):e0175982. doi: 10.1371/journal.pone.0175982. eCollection 2017. |
| 27793100 | Derived | Gomez-Marcos MA, Gomez-Sanchez L, Patino-Alonso MC, Recio-Rodriguez JI, Regalado NG, Ramos R, Marti R, Agudo-Conde C, Rodriguez-Sanchez E, Maderuelo-Fernandez JA, Garcia-Ortiz L; MARK Group. Association between markers of glycemia and carotid intima-media thickness: the MARK study. BMC Cardiovasc Disord. 2016 Oct 28;16(1):203. doi: 10.1186/s12872-016-0380-6. |
| 27776526 | Derived | Gomez-Sanchez L, Garcia-Ortiz L, Patino-Alonso MC, Recio-Rodriguez JI, Fernando R, Marti R, Agudo-Conde C, Rodriguez-Sanchez E, Maderuelo-Fernandez JA, Ramos R, Gomez-Marcos MA; MARK Group. Association of metabolic syndrome and its components with arterial stiffness in Caucasian subjects of the MARK study: a cross-sectional trial. Cardiovasc Diabetol. 2016 Oct 24;15(1):148. doi: 10.1186/s12933-016-0465-7. |
| 27177028 | Derived | Garcia-Ortiz L, Recio-Rodriguez JI, Mora-Simon S, Guillaumet J, Marti R, Agudo-Conde C, Rodriguez-Sanchez E, Maderuelo-Fernandez JA, Ramos-Blanes R, Gomez-Marcos MA; MARK Group. Vascular structure and function and their relationship with health-related quality of life in the MARK study. BMC Cardiovasc Disord. 2016 May 12;16:95. doi: 10.1186/s12872-016-0272-9. |
| 25885665 | Derived | Gomez-Sanchez L, Garcia-Ortiz L, Recio-Rodriguez JI, Patino-Alonso MC, Agudo-Conde C, Rigo F, Ramos R, Marti R, Gomez-Marcos MA; MARK Group. Leukocyte subtype counts and its association with vascular structure and function in adults with intermediate cardiovascular risk. MARK study. PLoS One. 2015 Apr 17;10(4):e0119963. doi: 10.1371/journal.pone.0119963. eCollection 2015. |
| 21992621 | Derived | Marti R, Parramon D, Garcia-Ortiz L, Rigo F, Gomez-Marcos MA, Sempere I, Garcia-Regalado N, Recio-Rodriguez JI, Agudo-Conde C, Feuerbach N, Garcia-Gil M, Ponjoan A, Quesada M, Ramos R. Improving interMediAte risk management. MARK study. BMC Cardiovasc Disord. 2011 Oct 13;11:61. doi: 10.1186/1471-2261-11-61. |
| D007238 |
| Infarction |
| D007511 | Ischemia |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D009336 | Necrosis |
| D002637 | Chest Pain |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D050197 | Atherosclerosis |
| D001161 | Arteriosclerosis |
| D001157 | Arterial Occlusive Diseases |
| D016491 | Peripheral Vascular Diseases |