Abstract 117: Does Lipoprotein (a) Impact the Classification of Intermediate to High Risk Patients using Reynold’s Risk Score
Introduction Elevated lipoprotein (a) (Lpa) has been linked repeatedly with cardiovascular disease (CVD) events. Two models of the Reynold’s Risk Score (RRS) A & B were validated to be effective predictors of CVD events. Lpa was included in RRS A but was excluded in RRS B. We sought to determine the proportion of patients (pts) that are reclassified into a different risk category utilizing RRS A instead of the simplified RRS B.
Methods Female pts with Lpa and data for RRS seen from 2006-12 at the Heart Centers for Women at RUMC and Emory Healthcare were included. Charts were reviewed for pt characteristics and biomarkers using Berkeley Heart Lab including: Total, LDL, and HDL cholesterol, triglycerides, ApoB, Lpa, HS-CRP, HgB A1c and history of hypertension, diabetes, current smoking, family history and blood pressure. HDL was substituted for ApoA1 in all cases in RRS A. RRS A and B were calculated. The proportions of pts within different risk strata were compared between the two models.
Results Of 604 women, 502 of them age 45 to 80 years old were included in this analysis, because RRS has been validated only in this age group. The table summarizes that a high proportion of women were reclassified into different risk strata using RRS B score.
Discussion The addition of Lpa reclassifies up to 81% of pts’ risk categories. Given that model A was the better fitting model, we propose the incorporation of Lpa in women whose risk is > 5% as determined by the simplified RRS B. Treatment implications may impact cardiovascular outcomes.
- © 2013 by American Heart Association, Inc.