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Long-Term Cardiovascular Risk Assessment in Portuguese Chronic Kidney Disease Population: Insights from the PREVENTTM Score
Session:
SESSÃO DE POSTERS 46 - EPIDEMIOLOGIA PORTUGUESA NO FOCO
Speaker:
Andreia Rita Henriques06
Congress:
CPC 2025
Topic:
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Theme:
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Subtheme:
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Session Type:
Cartazes
FP Number:
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Authors:
Andreia Rita Henriques; Tatiana Pereira Santos; João Venda; Emanuel Ferreira; Elisabete Jorge; Pedro Maia; Lino Gonçalves; Rui Alves
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Introduction:</strong> Traditional cardiovascular disease (CVC) risk scores overlook chronic kidney disease (CKD), limiting their applicability in these population The PREVENT™ score, which incorporates CKD, was recently approved in the United States. This study aims to evaluate the effectiveness of the newly approved PREVENT<sup>TM</sup> in predicting 10-year cardiovascular outcomes in a Portuguese CKD population.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Methods:</strong> A retrospective analysis included nephrology patients aged 30 – 79 years with eGFR <60 mL/min/1.73m², with no prior CVD, who attended nephrology appointments since 2013 at a tertiary hospital. Patients who died in the first year were excluded. The accuracy of PREVENT<sup>TM</sup>, SCORE2, and Kidney Failure Risk Equation (KFRE) in predicting CVD, heart failure (HF), and atherosclerotic cardiovascular disease (ASCVD) in CKD patients over a ten-year period were assessed. Secondary outcomes included all-cause mortality and dialysis initiation.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Results:</strong> A cohort of 125 patients (62.4% men, median age 65 [54 – 73] years, mean eGFR 35.8 ± 12.4 mL/min/1.73m<sup>2</sup>) was analysed. Higher PREVENT™ scores for CVD, HF, and ASCVD significantly correlated with the respective development of CVD (p=0.003; cut-off: 22.6%, sensitivity (SS) 77.4%, specificity (SE) 54.2%), HF (p=0.001; cut-off: 18.2%, SS 79.1%, SE 56.1%), and ASCVD (p=0.049; cut-off: 15.6%, SS 60.0%, SE 66.7%). While, SCORE2 also predicted CVD (p=0.017), PREVENT<sup>TM </sup>demonstrated superior sensitivity, and assign patients to higher risk classes, assigning 92.3% of patients to high or very high risk, compared to 53.0% of SCORE2. These findings highlight the CV risk in CKD patients and the need for introducing prognosis-modifying therapies in these patients.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">KFRE effectively predicted dialysis initiation, but neither PREVENT™ nor SCORE2 reached statistical significance for this outcome. Conversely, PREVENT™ correlated with higher all-cause mortality risk, a result not observed with KFRE.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Conclusions: </strong>CKD patients have an elevated risk of HF and CVD, emphasizing the need for accurate risk stratification. In this Portuguese cohort, PREVENT™ effectively estimated the risk of CV events, HF, and mortality, outperforming SCORE2 in sensitivity and risk classification. CKD-specific tools like PREVENT™ and KFRE complement one another, providing a more comprehensive risk assessment for this high-risk population.</span></span></p>
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