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. 2018 Nov 17;5(2):e000849.
doi: 10.1136/openhrt-2018-000849. eCollection 2018.

Risk classification in primary prevention of CVD according to QRISK2 and JBS3 'heart age', and prevalence of elevated high-sensitivity C reactive protein in the UK cohort of the EURIKA study

Ieuan Johns  1 , Konstantinos E Moschonas  2 , Jesús Medina  3 , Nicholas Ossei-Gerning  4 , George Kassianos  5 , Julian P Halcox  6
Affiliations

Risk classification in primary prevention of CVD according to QRISK2 and JBS3 'heart age', and prevalence of elevated high-sensitivity C reactive protein in the UK cohort of the EURIKA study

Ieuan Johns et al. Open Heart. .

Abstract

Objectives: This study assessed cardiovascular disease (CVD) risk classification according to QRISK2, JBS3 'heart age' and the prevalence of elevated high-sensitivity C reactive protein (hsCRP) in UK primary prevention patients.

Method: The European Study on Cardiovascular Prevention and Management in Usual Daily Practice (EURIKA) (NCT00882336) was a cross-sectional study conducted in 12 European countries. 673 UK outpatients aged ≥50 years, without clinical CVD but with at least one conventional CVD risk factor, were recruited. 10-year CVD risk was calculated using QRISK2. JBS3 'heart age' and hsCRP level were assessed according to risk category.

Results: QRISK2 and JBS3 heart age was calculated for 285 of the 305 patients free from diabetes mellitus and not receiving a statin. QRISK2 classified 28%, 39% and 33% of patients as low (<10%), intermediate (10% to <20%) and high (≥20%) risk, respectively. Two-thirds of low-risk patients and half of intermediate-risk patients had a heart age ≥5 years and ≥10 years higher than their chronological age, respectively. Half of low-risk patients had hsCRP levels ≥2 mg/L and approximately 40% had levels ≥3 mg/L. Approximately 80% of low-risk patients had both elevated hsCRP and heart age relative to their chronological age.

Conclusions: Almost 40% more patients in this 'at risk' group would be eligible for statin therapy following the lowering of the National Institute for Health and Care Excellence treatment threshold to ≥10% 10-year risk. Of patients falling below this treatment threshold, almost all were at increased lifetime risk as measured by JBS3, and of these, the majority had elevated hsCRP levels. These patients with high absolute risk may benefit from early primary CVD prevention.

Keywords: inflammation; risk factors; risk stratification; statins.

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Conflict of interest statement

Competing interests: JPH has received fees for participation in review activities for AstraZeneca, is a consultant and has received payment for lecturing, development of educational presentations from Astra Zeneca, is a consultant for Abbott, Pfizer, Roche and MSD and has received fees for lecturing from Abbott, Roche, MSD and Takeda as well as has had accommodation and meeting expenses covered from Abbott. JM works for Astra Zeneca. GK has received payment for manuscript preparations (not including the current one) by the Guidelines Board for management of myalgia in patients taking statins.

Figures

Figure 1
Figure 1
High-sensitivity C reactive protein (hsCRP) levels in the total UK cohort.
Figure 2
Figure 2
High-sensitivity C reactive protein (hsCRP) levels according to cardiovascular disease risk as calculated by QRISK2 in patients free from diabetes and not receiving a statin.
Figure 3
Figure 3
Difference between JBS3 ‘heart age’ and chronological age for cohort and according to QRISK2 10-year cardiovascular disease risk category.
Figure 4
Figure 4
High-sensitivity C(hsCRP) levels according to difference between JBS3 ‘heart age’ and chronological age.
See this image and copyright information in PMC

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