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Use of clinical scores in young Australian adults for prediction of atherosclerosis in middle age


Huynh, Q and Venn, AJ and Magnussen, CG and Yang, H and Venkataraman, P and Dwyer, T and Marwick, TH, Use of clinical scores in young Australian adults for prediction of atherosclerosis in middle age, BMC Cardiovascular Disorders, 23 Article 63. ISSN 1471-2261 (2023) [Refereed Article]

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Copyright Statement

The Author(s) 2023. This article is licensed under a Creative Commons Attribution 4.0 International International (CC BY 4.0) License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format.

DOI: doi:10.1186/s12872-023-03060-x


We sought to apply a simple cardiovascular health tool not requiring laboratory tests (the Fuster-BEWAT score, FBS) to predict subclinical atherosclerosis. This study included 2657 young adults (<40 years of age). In the prognostic group (n=894, followed for 13 years until aged 4050 years at follow-up), the primary outcome was presence of carotid plaque measured by carotid ultrasound at follow-up. Of these 894 participants, 86 (9.6%) had unilateral, and 23 participants (2.6%) had bilateral, carotid plaques at follow-up. The baseline FBS was predictive of carotid plaque at follow-up [odds ratio OR=0.86 (95% CI 0.770.96) per 1-SD increase in FBS], similar to prediction from Pooled Cohort Equation [PCE, OR=0.72 (0.610.85) per 1-SD decrease in PCE]. Risk scores at baseline predicted outcomes more strongly than those at follow-up, and did so independently of any changes over 13 years of follow-up. Similar discrimination for predicting carotid plaque after 13 years was found for both baseline FBS [C-statistic=0.68 (95% CI 0.620.74)] and PCE [C-statistic=0.69 (95% CI 0.630.75)]. Application of this FBS prognostic information to a contemporary cohort of 1763 young adults anticipates the future development of plaque in 305 (17.3%), especially in the 1494 participants (85%) with≤2 metrics of ideal health. In conclusions, FBS measured in young adulthood predicted atherosclerosis 13 years later in middle age, independent of score changes over the follow-up period, emphasizing the importance of early damage to vascular health. FBS may be a simple and feasible risk score for engaging low-risk young people with reduction of future cardiovascular risk.

Item Details

Item Type:Refereed Article
Keywords:clinical score, atherosclerosis, atherosclerotic risk, carotid plaque, Fuster BEWAT score, ideal cardiovascular health score, pooled cohort equation
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Cardiology (incl. cardiovascular diseases)
Objective Division:Health
Objective Group:Clinical health
Objective Field:Prevention of human diseases and conditions
UTAS Author:Huynh, Q (Dr Quan Huynh)
UTAS Author:Venn, AJ (Professor Alison Venn)
UTAS Author:Magnussen, CG (Associate Professor Costan Magnussen)
UTAS Author:Yang, H (Ms Hilda Yang)
UTAS Author:Dwyer, T (Professor Terry Dwyer)
UTAS Author:Marwick, TH (Professor Tom Marwick)
ID Code:155439
Year Published:2023
Deposited By:Menzies Institute for Medical Research
Deposited On:2023-02-20
Last Modified:2023-03-21

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