{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T13:53:35Z","timestamp":1772286815597,"version":"3.50.1"},"reference-count":25,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2022,7,29]],"date-time":"2022-07-29T00:00:00Z","timestamp":1659052800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["FDN 143313"],"award-info":[{"award-number":["FDN 143313"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["FDN 154333"],"award-info":[{"award-number":["FDN 154333"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009227","name":"Department of Medicine, University of Toronto","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009227","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004411","name":"Heart and Stroke Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004411","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Canada Research Chair in Structural Heart Disease Policy and Outcomes"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Estimation of an individual's cardiovascular disease (CVD) risk may enhance risk discussion and treatment decisions. Yet, common cardiovascular outcomes such as heart failure (HF) or coronary revascularization are not included in the estimation of atherosclerotic cardiovascular disease (ASCVD) risk. Our objective was to determine the incidence of ASCVD in a contemporary primary prevention population with &amp;gt;10 years of follow-up and how incidence estimates change when incorporating additional cardiovascular endpoints.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We used the population-level Cardiovascular Health in Ambulatory Care Research Team database of all Ontario residents alive 1 January 2008, aged 30\u201399 years, and with no prior history of CVD. Individuals were followed to 31 December 2018 for incident first and recurrent cardiovascular events. ASCVD outcomes were defined by hospitalizations for myocardial infarction, stroke, and circulatory death, while global CVD outcomes also included hospitalizations for unstable angina, transient ischemic attacks, peripheral arterial disease, out-of-hospital cardiac arrests, HF, and coronary revascularization.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 7496\u00a0165 individuals free of CVD, their mean age was 50 years (SD: 13.9 years) and 52.3% were women. After 11 years of follow-up, the rate of an incident ASCVD event was 3.95 per 1000 person-years, while the rate of a global CVD event was almost doubled at 6.67 per 1000 person-years. The most common additional first manifestations of CVD were HF, which accounted for 12.0% of additional events and coronary revascularization, which accounted for 12.7%. When considering first and recurrent events, the rate of ASCVD was 5.20 per 1000 person-years, while the rate of all global CVD events was more than double at 10.90 per 1000 person-years. This was mainly due to a higher proportion of recurrent HF (13.8%) and coronary revascularization (23.2%) events.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>ASCVD accounts for just over half of all preventable first cardiovascular events and even fewer first and recurrent cardiovascular events in contemporary practice. Estimating broader CVD endpoints may enhance risk-discussions with patients and improve informed decision-making.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjqcco\/qcac044","type":"journal-article","created":{"date-parts":[[2022,7,29]],"date-time":"2022-07-29T12:39:13Z","timestamp":1659098353000},"source":"Crossref","is-referenced-by-count":2,"title":["Impact of outcome definitions on cardiovascular risk prediction in a contemporary primary prevention population"],"prefix":"10.1093","author":[{"given":"Maneesh","family":"Sud","sequence":"first","affiliation":[{"name":"Schulich Heart Program, Sunnybrook Health Sciences Centre, University of Toronto , Toronto, ON M4N 3M5, Canada"},{"name":"Institute of Health Policy Management, and Evaluation, University of Toronto , Toronto, ON M5T 3M6 , Canada"},{"name":"ICES , 2075 Bayview Ave, G106 Toronto , ON M4N 3M5 Canada"},{"name":"Temerty Faculty of Medicine, University of Toronto , Toronto, ON M5S 1A8 , 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Toronto, ON M5S 1A8 , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Thanassoulis","sequence":"additional","affiliation":[{"name":"Department of Medicine, McGill University , Montreal, QC H4A 3J1 Canada"},{"name":"Department of Medicine, Division of Cardiology, McGill Universiy Health Centre , Montreal, QC H4A 3J1 Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harindra C","family":"Wijeysundera","sequence":"additional","affiliation":[{"name":"Schulich Heart Program, Sunnybrook Health Sciences Centre, University of Toronto , Toronto, ON M4N 3M5, Canada"},{"name":"Institute of Health Policy Management, and Evaluation, University of Toronto , Toronto, ON M5T 3M6 , Canada"},{"name":"ICES , 2075 Bayview Ave, G106 Toronto , ON M4N 3M5 Canada"},{"name":"Temerty Faculty of Medicine, University of Toronto , Toronto, ON M5S 1A8 , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dennis 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