ACCF/AHA 2009 performance measures for primary prevention of cardiovascular disease in adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Performance Measures (Writing Committee to Develop Performance Measures for Primary Prevention of Cardiovascular Disease) developed in collaboration with the American Academy of Family Physicians; American Association of Cardiovascular and Pulmonary Rehabilitation; and Preventive Cardiovascular Nurses Ass

Journal of the American College of Cardiology (Impact Factor: 16.5). 09/2009; 54(14):1364-405.
Source: PubMed
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    • "Other relevant risk factors associated with CHD and CVD risk18,52 such as obesity, low levels of physical activity, poor diet/nutrition, alcohol consumption, use of antihypertensive medication, chronic kidney disease, and coronary artery calcium have not been incorporated into some of these models. Only BMI was included in the simplified general CVD risk score model. "
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    ABSTRACT: Although elevated cardiovascular disease (CVD) risk factors are associated with a higher risk of developing heart conditions across all ethnic groups, variations exist between groups in the distribution and association of risk factors, and also risk levels. This study assessed the 10-year predicted risk in a multiethnic cohort of women and compared the differences in risk between Asian and Caucasian women. Information on demographics, medical conditions and treatment, smoking behavior, dietary behavior, and exercise patterns were collected. Physical measurements were also taken. The 10-year risk was calculated using the Framingham model, SCORE (Systematic COronary Risk Evaluation) risk chart for low risk and high risk regions, the general CVD, and simplified general CVD risk score models in 4,354 females aged 20-69 years with no heart disease, diabetes, or stroke at baseline from the third Australian Risk Factor Prevalence Study. Country of birth was used as a surrogate for ethnicity. Nonparametric statistics were used to compare risk levels between ethnic groups. Asian women generally had lower risk of CVD when compared to Caucasian women. The 10-year predicted risk was, however, similar between Asian and Australian women, for some models. These findings were consistent with Australian CVD prevalence. In summary, ethnicity needs to be incorporated into CVD risk assessment. Australian standards used to quantify risk and treat women could be applied to Asians in the interim. The SCORE risk chart for low-risk regions and Framingham risk score model for incidence are recommended. The inclusion of other relevant risk variables such as obesity, poor diet/nutrition, and low levels of physical activity may improve risk estimation.
    International Journal of Women's Health 03/2014; 6(1):259-67. DOI:10.2147/IJWH.S55225
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    • "All subjects provided a signed, written informed consent at entry into the study, and all patients agreed with the invasive assessment using coronary angiography. After inception, patients were treated according to the current guidelines for treatment of patients with, or at high-risk for, CVD [12,13] including 72 patients referred for myocardial revascularization procedures (coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI)). After cardiovascular risk stratification, patients were referred back to the renal transplant unit for follow-up and inclusion/exclusion in transplant waiting lists. "
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    ABSTRACT: Renal transplant candidates are at high risk of coronary artery disease (CAD). We sought to develop a new risk score model to determine the pre-test probability of the occurrence of significant CAD in renal transplant candidates. A total of 1,060 renal transplant candidates underwent a comprehensive cardiovascular risk evaluation. Patients considered at high risk of CAD (age >=50 years, with either diabetes mellitus (DM) or cardiovascular disease (CVD)), or having noninvasive testing suggestive of CAD were referred for coronary angiography (n = 524). Significant CAD was defined by the presence of luminal stenosis >=70%. A binary logistic regression model was built, and the resulting logistic regression coefficient B for each variable was multiplied by 10 and rounded to the next whole number. For each patient, a corresponding risk score was calculated and the receiver operating characteristic (ROC) curve was constructed. The final equation for the model was risk score = (age x 0.4) + (DM x 9) + (CVD x 14) and for the probability of CAD (%) = (risk score x 2) -- 23. The corresponding ROC for the accuracy of the diagnosis of CAD was 0.75 (P <0.0001) in the developmental model. We developed a simple clinical risk score to determine the pre-test probability of significant CAD in renal transplant candidates. This model may help those directly involved in the care of patients with end-stage renal disease being considered for transplantation in an attempt to reduce the rate of cardiovascular events that presently hampers the long-term prognosis of such patients.
    11/2013; 2(1):18. DOI:10.1186/2047-1440-2-18
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    • "This step may generate future comparisons. Finally, documentation of cardiovascular risk factors, such as cholesterol and blood pressure levels, is essential for evaluating an individual's risk of heart disease [16]. Documentation rates of these factors have increased between 4%-15% from 2007 to 2009 and likely reflect the increased attention of the healthcare system to cardiovascular risks. "
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    ABSTRACT: The National Program for Quality Indicators in Community Healthcare in Israel (QICH) was developed to provide policy makers and consumers with information on the quality of community healthcare in Israel. In what follows we present the most recent results of the QICH indicator set for 2009 and an examination of changes that have occurred since 2007. Data for 28 quality indicators were collected from all four health plans in Israel for the years 2007-2009. The QICH indicator set examined six areas of healthcare: asthma, cancer screening, cardiovascular health, child health, diabetes and immunizations for older adults. Dramatic increases in the documentation of anthropometric measures were observed over the measurement period. Documentation of BMI for adolescents and adults increased by 30 percentage points, reaching rates of 61% and 70%, respectively, in 2009. Modest increases (3%-7%) over time were observed for other primary prevention quality measures including immunizations for older adults, cancer screening, anemia screening for young children, and documentation of cardiovascular risks. Overall, rates of recommended care for chronic diseases (asthma, cardiovascular disease and diabetes) increased over time. Changes in rates of quality care for diabetes were varied over the measurement period. The overall quality of community healthcare in Israel has improved over the past three years. Future research should focus on the adherence to quality indicators in population subgroups and compare the QICH data with those in other countries. In addition, one of the next steps in assessing and further improving healthcare quality in Israel is to relate these process and performance indicators to health outcomes.
    Israel Journal of Health Policy Research 01/2012; 1(1):3. DOI:10.1186/2045-4015-1-3
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