Examinando por Autor "Cohorts Consortium of Latin America and the Caribbean (CC-LAC)"
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Ítem Derivation, internal validation, and recalibration of a cardiovascular risk score for Latin America and the Caribbean (Globorisk-LAC): A pooled analysis of cohort studies(The Lancet Regional Health - Americas, 9, 2022) Stern, Dalia; Hambleton, Ian R.; Lotufo, Paulo Andrade; Di Cesare, Mariachiara; Hennis, Anselm; Ferreccio, Catterina; Irazola, Vilma; Perel, Pablo; Gregg, Edward W.; Aguilar Salinas, Carlos Alberto; Álvarez Vaz, Ramón; Amadio, Marselle Bevilacqua; Baccino, Cecilia; Bambs S., Claudia; Bastos, João Luiz Dornelles; Beckles, Gloria; Bernabé Ortiz, Antonio; Bernardo, Carla; Bloch, Katia Vergetti; Blümel, Juan Enrique; Boggia, José G.; Borges, Pollyana Kássia de Oliveira; Bravo, Miguel; Brenes Camacho, Gilbert; Carbajal, Horacio A.; Casas Vásquez, Paola; Castillo Rascón, María Susana; Ceballos, Blanca H.; Colpani, Verônica; Cooper, Jackie A.; Cortés, Sandra; Cortés Valencia, Adrián; de Sá Cunha, Roberto; d'Orsi, Eleonora; Dow, William H.; Espeche, Walter G.; Fuchs, Flavio Danni; Pereira Costa Fuchs, Sandra Cristina; Godoy Agostinho Gimeno, Suely; Gómez Velasco, Donaji Verónica; González Chica, David Alejandro; González Villalpando, Clicerio; González Villalpando, María Elena; Grazioli, Gonzalo; Guerra, Ricardo Oliveira; Gutierrez, Laura E.; Herkenhoff Vieira, Fernando Luiz; Horimoto, Andrea Roseli Vancan Russo; Huidobro Muñoz, Laura Andrea; Koch, Elard S.; Lajous Loaeza, Martin; Furtado de Lima e Costa, Maria Fernanda; López Ridaura, Ruy; Campos Cavalcanti Maciel, Álvaro; Maestre, Gladys Elena; Manrique Espinoza, Betty Soledad; Marques, Larissa Pruner; Melgarejo Arias, Jesus David; Mena Camaré, Luis Javier; Mill, Jose Gerardo; Moreira, Leila Beltrami; Muñoz Velandia, Oscar Mauricio; Ono, Lariane Mortean; Oppermann, Karen; Ortiz Saavedra, Pedro José; de Paiva, Karina Mary; Viana Peixoto, Sérgio William; da Costa Pereira, Alexandre; Peres, Karen G.; de Anselmo Peres, Marco Aurelio; Ramírez Palacios, Paula; Rech, Cassiano Ricardo; Rivera Paredez, Berenice; Rodríguez Guerrero, Nohora Inés; Rojas Martínez, Maria Rosalba; Rosero Bixby, Luis; Rubinstein, Adolfo; Ruiz Morales, Álvaro de Jesus; Salazar, Martin R.; Salinas Rodríguez, Aarón; Nájera Salmerón, Jorge Alberto; Sánchez, Ramón Augusto; de Souza e Silva, Nelson Albuquerque; Nogueira da Silva, Thiago Luiz; Smeeth, Liam; Spritzer, Poli Mara; Tartaglione, Fiorella; Tartaglione, Jorge; Tello Rodríguez, Tania; Velázquez Cruz, Rafael; Cohorts Consortium of Latin America and the Caribbean (CC-LAC); Carrillo Larco, Rodrigo Martín; Miranda Montero, Juan J.; Ezzati, Majid; Danaei, GoodarzBackground: Risk stratification is a cornerstone of cardiovascular disease (CVD) prevention and a main strategy proposed to achieve global goals of reducing premature CVD deaths. There are no cardiovascular risk scores based on data from Latin America and the Caribbean (LAC) and it is unknown how well risk scores based on European and North American cohorts represent true risk among LAC populations. Methods: We developed a CVD (including coronary heart disease and stroke) risk score for fatal/non-fatal events using pooled data from 9 prospective cohorts with 21,378 participants and 1,202 events. We developed laboratory based (systolic blood pressure, total cholesterol, diabetes, and smoking), and office-based (body mass index replaced total cholesterol and diabetes) models. We used Cox proportional hazards and held back a subset of participants to internally validate our models by estimating Harrell’s C-statistic and calibration slopes. Findings: The C-statistic for the laboratory-based model was 72% (70−74%), the calibration slope was 0.994 (0.934−1.055) among men and 0.852 (0.761−0.942) among women; for the office-based model the C-statistic was 71% (69−72%) and the calibration slope was 1.028 (0.980−1.076) among men and 0.811 (0.663−0.958) among women. In the pooled sample, using a 20% risk threshold, the laboratory-based model had sensitivity of 21.9% and specificity of 94.2%. Lowering the threshold to 10% increased sensitivity to 52.3% and reduced specificity to 78.7%. Interpretation: The cardiovascular risk score herein developed had adequate discrimination and calibration. The Globorisk-LAC would be more appropriate for LAC than the current global or regional risk scores. This work provides a tool to strengthen risk-based cardiovascular prevention in LAC.Ítem Impact of common cardio-metabolic risk factors on fatal and non-fatal cardiovascular disease in Latin America and the Caribbean: an individual-level pooled analysis of 31 cohort studies(The Lancet Regional Health - Americas, vol.4, 2021) Cohorts Consortium of Latin America and the Caribbean (CC-LAC)Background: Estimates of the burden of cardio-metabolic risk factors in Latin America and the Caribbean (LAC) rely on relative risks (RRs) from non-LAC countries. Whether these RRs apply to LAC remains un- known. Methods: We pooled LAC cohorts. We estimated RRs per unit of exposure to body mass index (BMI), systolic blood pressure (SBP), fasting plasma glucose (FPG), total cholesterol (TC) and non-HDL cholesterol on fatal (31 cohorts, n = 168,287) and non-fatal (13 cohorts, n = 27,554) cardiovascular diseases, adjusting for regression dilution bias. We used these RRs and national data on mean risk factor levels to estimate the number of cardiovascular deaths attributable to non-optimal levels of each risk factor. Results: Our RRs for SBP, FPG and TC were like those observed in cohorts conducted in high-income countries; however, for BMI, our RRs were consistently smaller in people below 75 years of age. Across risk factors, we observed smaller RRs among older ages. Non-optimal SBP was responsible for the largest number of attributable cardiovascular deaths ranging from 38 per 10 0,0 0 0 women and 54 men in Peru, to 261 (Dominica, women) and 282 (Guyana, men). For non-HDL cholesterol, the lowest attributable rate was for women in Peru (21) and men in Guatemala (25), and the largest in men (158) and women (142) from Guyana. Interpretation: RRs for BMI from studies conducted in high-income countries may overestimate disease burden metrics in LAC; conversely, RRs for SBP, FPG and TC from LAC cohorts are similar to those esti- mated from cohorts in high-income countries.