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Effect of carotid image-based phenotypes on cardiovascular risk calculator: AECRS1.0

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Abstract

Today, the 10-year cardiovascular risk largely relies on conventional cardiovascular risk factors (CCVRFs) and suffers from the effect of atherosclerotic wall changes. In this study, we present a novel risk calculator AtheroEdge Composite Risk Score (AECRS1.0), designed by fusing CCVRF with ultrasound image-based phenotypes. Ten-year risk was computed using the Framingham Risk Score (FRS), United Kingdom Prospective Diabetes Study 56 (UKPDS56), UKPDS60, Reynolds Risk Score (RRS), and pooled composite risk (PCR) score. AECRS1.0 was computed by measuring the 10-year five carotid phenotypes such as IMT (ave., max., min.), IMT variability, and total plaque area (TPA) by fusing eight CCVRFs and then compositing them. AECRS1.0 was then benchmarked against the five conventional cardiovascular risk calculators by computing the receiver operating characteristics (ROC) and area under curve (AUC) values with a 95% CI. Two hundred four IRB-approved Japanese patients’ left/right common carotid arteries (407 ultrasound scans) were collected with a mean age of 69 ± 11 years. The calculators gave the following AUC: FRS, 0.615; UKPDS56, 0.576; UKPDS60, 0.580; RRS, 0.590; PCRS, 0.613; and AECRS1.0, 0.990. When fusing CCVRF, TPA reported the highest AUC of 0.81. The patients were risk-stratified into low, moderate, and high risk using the standardized thresholds. The AECRS1.0 demonstrated the best performance on a Japanese diabetes cohort when compared with five conventional calculators.

AECRS1.0: Carotid ultrasound image phenotype-based 10-year cardiovascular risk calculator. The figure provides brief overview of the proposed carotid image phenotype-based 10-year cardiovascular risk calculator called AECRS1.0. AECRS1.0 was also benchmarked against five conventional cardiovascular risk calculators (Framingham Risk Score (FRS), United Kingdom Prospective Diabetes Study 56 (UKPDS56), UKPDS60, Reynolds Risk Score (RRS), and pooled composite risk (PCR) score).

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  2. As it is coined from original research article

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Authors and Affiliations

  1. Department of Cardiology, Indraprastha Apollo Hospitals, New Delhi, India

    Narendra N. Khanna

  2. Department of ECE, Visvesvaraya National Institute of Technology, Nagpur, Maharashtra, India

    Ankush D. Jamthikar & Deep Gupta

  3. Division of Cardiovascular Medicine, Toho University, Tokyo, Japan

    Tadashi Araki

  4. Department of Rheumatology, University of Cagliari, Cagliari, Italy

    Matteo Piga

  5. Department of Radiology, University of Cagliari, Cagliari, Italy

    Luca Saba

  6. Department of Genetics, University of Cagliari, Cagliari, Italy

    Carlo Carcassi

  7. Vascular Diagnostic Center, University of Cyprus, Nicosia, Cyprus

    Andrew Nicolaides

  8. Heart and Vascular Institute, Adventist Health St. Helena, St. Helena, CA, USA

    John R. Laird

  9. Brown University, Providence, RI, USA

    Harman S. Suri

  10. Department of Radiology, Cornell Medical Center, New York, NY, USA

    Ajay Gupta

  11. Cardiology Clinic, Onassis Cardiac Surgery Center, Athens, Greece

    Sophie Mavrogeni

  12. Department of Cardiovascular Prevention & Research Unit Clinic & Laboratory of Pathophysiology, National and Kapodistrian University of Athens, Athens, Greece

    Athanasios Protogerou

  13. Rheumatology Unit, National Kapodistrian University of Athens, Athens, Greece

    Petros Sfikakis

  14. Research & Development-Academic Affairs, Dudley Group NHS Foundation Trust, Dudley, UK

    George D. Kitas

  15. Stroke Monitoring and Diagnostic Division, AtheroPoint™, 208 Otter Glen CT, Roseville, CA, 95661, USA

    Jasjit S. Suri

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  1. Narendra N. Khanna
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Dr. Jasjit Suri is affiliated to AtheroPoint™, focused on the area of stroke and cardiovascular imaging.

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Khanna, N.N., Jamthikar, A.D., Gupta, D. et al. Effect of carotid image-based phenotypes on cardiovascular risk calculator: AECRS1.0. Med Biol Eng Comput 57, 1553–1566 (2019). https://doi.org/10.1007/s11517-019-01975-2

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