What is the equation for 10-year cardiac risk assessment, also known as Atherosclerotic Cardiovascular Disease (ASCVD) risk assessment?

From the Guidelines

The Pooled Cohort Equations (PCE) are the recommended tool for 10-year cardiovascular risk assessment, estimating the probability of experiencing a first atherosclerotic cardiovascular disease event within the next 10 years. The equation incorporates several key variables including age, sex, race (specifically distinguishing between African American and non-African American), total cholesterol, HDL cholesterol, systolic blood pressure, treatment for hypertension, diabetes status, and smoking status 1. To use this tool in practice, you would input these patient-specific values into the equation or use an online calculator provided by the American College of Cardiology/American Heart Association.

Key Variables

• Age
• Sex
• Race (African American or non-African American)
• Total cholesterol
• HDL cholesterol
• Systolic blood pressure
• Treatment for hypertension
• Diabetes status
• Smoking status The resulting percentage represents the patient's 10-year risk, with values ≥7.5% generally considered elevated risk that may warrant consideration of statin therapy, as supported by the 2018 cholesterol clinical practice guidelines 1. The equations were developed from multiple large-scale cohort studies, including the ARIC, Cardiovascular Health Study, and the CARDIA study, and provide more accurate risk prediction than previous models by accounting for race-specific risk factors and incorporating diabetes as a variable 1. For patients aged 40-79 without existing cardiovascular disease, this assessment should be performed every 4-6 years as part of routine preventive care.

Implementation in Practice

• Input patient-specific values into the equation or use an online calculator
• Consider statin therapy for patients with a 10-year risk ≥7.5%
• Perform assessment every 4-6 years for patients aged 40-79 without existing cardiovascular disease It is essential to note that the PCE has undergone external validation studies and has been subjected to more rigorous validation than other currently available equations, making it a reliable tool for cardiovascular risk assessment 1.

From the Research

Equation for 10-Year Cardiac Risk Assessment

The equation for 10-year cardiac risk assessment is not explicitly provided in the given studies. However, the studies discuss various models and equations used for predicting 10-year risk of cardiovascular disease, including:

• The Pooled Cohort Equations (PCEs) 2, 3, 4
• The Framingham risk models 4
• The PREVENT equations, which include the urine albumin/creatinine ratio, glycated hemoglobin, and social deprivation index 2

Key Findings

• The PCEs and PREVENT equations have been compared for their performance in predicting 10-year ASCVD risk, with the PREVENT equations showing improved performance in certain populations 2
• The Framingham risk models and PCEs have been found to overestimate the 10-year risk of CHD and CVD, especially in high-risk individuals and European populations 4
• Statin therapy is a primary pharmacologic intervention for ASCVD risk reduction, and various guidelines have been published for statin use in primary prevention 3, 5
• The presence or absence of coronary artery calcium (CAC) can be used to identify individuals with healthy arterial aging, who may have a lower risk of ASCVD events 6

Models and Equations

• The PCEs are widely used for predicting 10-year risk of cardiovascular disease, but have been found to overestimate risk in certain populations 2, 3, 4
• The Framingham risk models are also widely used, but have been found to have limitations in certain populations 4
• The PREVENT equations are a newer model that includes additional risk factors, such as urine albumin/creatinine ratio and social deprivation index 2