Background Estimation of atherosclerotic cardiovascular disease (ASCVD) risk is a key step in cardiovascular disease (CVD) prevention, but it requires entering additional risk factor information into a computer. We developed a simplified ASCVD risk score that can be automatically calculated by the clinical laboratory when a fasting standard lipid panel is reported. Methods Equations for an estimated ASCVD (eASCVD) risk score were developed for 4 race/sex groups (non-Hispanic White/Black, men/women), using the following variables: total cholesterol, high-density lipoprotein cholesterol, triglycerides, and age. The eASCVD score was derived using regression analysis to yield similar risk estimates as the standard ASCVD risk equations for non-diabetic individuals not on lipid-lowering therapy in the National Health and Nutrition Examination Survey (NHANES) (n = 6027). Results At a cutpoint of 7.5%/10-year, the eASCVD risk score had an overall sensitivity of 69.1% and a specificity of 97.5% for identifying statin-eligible patients with at least intermediate risk based on the standard risk score. By using the sum of other risk factors present (systolic blood pressure >130 mmHg, blood pressure medication use, and cigarette use), the overall sensitivity of the eASCVD score improved to 93.7%, with a specificity of 92.3%. Furthermore, it showed 90% concordance with the standard risk score in predicting cardiovascular events in the Atherosclerosis Risk in Communities (ARIC) study (n = 14 742). Conclusions Because the automated eASCVD risk score can be computed for all patients with a fasting standard lipid panel, it could be used as an adjunctive tool for the primary prevention of ASCVD and as a decision aid for statin therapy.

中文翻译：

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估计的动脉粥样硬化心血管疾病风险评分：他汀类药物治疗的自动决策辅助

背景 动脉粥样硬化性心血管疾病 (ASCVD) 风险的估计是心血管疾病 (CVD) 预防的关键步骤，但它需要将额外的风险因素信息输入计算机。我们开发了一个简化的 ASCVD 风险评分，当报告空腹标准脂质面板时，临床实验室可以自动计算该评分。方法 使用以下变量为 4 个种族/性别组（非西班牙裔白人/黑人、男性/女性）开发了估计的 ASCVD (eASCVD) 风险评分方程：总胆固醇、高密度脂蛋白胆固醇、甘油三酯和年龄. eASCVD 评分是使用回归分析得出的，以得出与国家健康和营养调查 (NHANES) (n = 6027) 中未接受降脂治疗的非糖尿病个体的标准 ASCVD 风险方程相似的风险估计。结果 在 7.5%/10 年的临界点上，eASCVD 风险评分在基于标准风险评分识别至少具有中度风险的符合他汀类药物条件的患者方面具有 69.1% 的总体敏感性和 97.5% 的特异性。通过使用存在的其他风险因素（收缩压 > 130 mmHg、血压药物使用和吸烟）的总和，eASCVD 评分的总体敏感性提高到 93.7%，特异性为 92.3%。此外，在社区动脉粥样硬化风险 (ARIC) 研究 (n = 14 742) 中，它与预测心血管事件的标准风险评分有 90% 的一致性。结论 由于可以计算所有具有空腹标准脂质组的患者的自动 eASCVD 风险评分，它可以用作 ASCVD 一级预防的辅助工具和他汀类药物治疗的决策辅助工具。