{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T14:48:04Z","timestamp":1782917284097,"version":"3.54.5"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2023YFC2506900"],"award-info":[{"award-number":["2023YFC2506900"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82504493"],"award-info":[{"award-number":["82504493"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The American Heart Association's Predicting Risk of Cardiovascular Disease Events (PREVENT) equations predict cardiovascular risk, but their utility in perioperative settings is unclear. This study aims to evaluate the association between PREVENT equations and postoperative cardiovascular events in thoracic surgical population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective study included 1,073 patients undergoing thoracic surgery at Nanfang Hospital, Southern Medical University, between January 2019 and October 2023. The sex-specific PREVENT risk scores for atherosclerotic cardiovascular disease (ASCVD), coronary heart disease (CHD), heart failure (HF), and total cardiovascular disease (CVD) were calculated. The study outcome was 30-day postoperative composite events of major adverse cardiac and cerebral events (MACCE: composite of angina, myocardial injury, stroke, and HF). The single event or composition combinations matched to PREVENT risk scores were also assessed: angina, HF, angina or myocardial injury (AMI), AMI or stroke (AMIS). Multivariate logistic regression was used to evaluate MACCE risk, with false discovery rate (FDR) correction for\n                      <jats:italic>P<\/jats:italic>\n                      values. The discriminative ability was assessed using receiver operating characteristic (ROC) curves and area under the curve (AUC).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median age of included patients was 58 years old. In females, one standard-deviation (SD) increase in the ASCVD score was significantly associated with higher odds of postoperative angina (OR\u2009=\u20091.95, 95% CI: 1.19\u20133.21, FDR corrected\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.0381). CHD score was significantly associated with female angina (OR\u2009=\u20091.83, 95% CI: 1.14\u20132.95, FDR corrected\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.0354) and AMI (OR\u2009=\u20091.46, 95% CI: 1.05\u20132.03, FDR corrected\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.0386). In males, no PREVENT risk scores were significantly associated with major adverse cardiac and cerebral events (all FDR corrected\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;gt;\u20090.05). The PREVENT equations demonstrated light to moderate discrimination, with AUCs ranging from 0.65 to 0.75 in female patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The PREVENT equations demonstrated preliminary associations with 30-day postoperative MACCE in non-cardiac thoracic surgical female patients, but not in male patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1823917","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T13:57:37Z","timestamp":1782914257000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Application of predicting risk of cardiovascular disease events equations on postoperative major adverse cardiac and cerebral events for patients undergoing thoracic surgery"],"prefix":"10.3389","volume":"13","author":[{"given":"Wan-Qiu","family":"Fan","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Second Affiliated Hospital of Army Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Nanfang Hospital, Southern Medical University","place":["Guangzhou, Guangdong, China"]},{"name":"Guangdong Provincial Key Laboratory of Precision Anesthesia and Perioperative Organ Protection, Nanfang Hospital, Southern Medical University","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Er-Yi","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Nanfang Hospital, Southern Medical University","place":["Guangzhou, Guangdong, China"]},{"name":"Guangdong Provincial Key Laboratory of Precision Anesthesia and Perioperative Organ Protection, Nanfang Hospital, Southern Medical University","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Yu","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Second Affiliated Hospital of Army Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Kai","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Second Affiliated Hospital of Army Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Second Affiliated Hospital of Army Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ke-Xuan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Nanfang Hospital, Southern Medical University","place":["Guangzhou, Guangdong, China"]},{"name":"Guangdong Provincial Key Laboratory of Precision Anesthesia and Perioperative Organ Protection, Nanfang Hospital, Southern Medical University","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua-Min","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Nanfang Hospital, Southern Medical University","place":["Guangzhou, Guangdong, China"]},{"name":"Guangdong Provincial Key Laboratory of Precision Anesthesia and Perioperative Organ Protection, Nanfang Hospital, Southern Medical University","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"946","DOI":"10.1016\/S1474-4422(23)00209-0","article-title":"Prevention of perioperative stroke in patients undergoing non-cardiac surgery","volume":"22","author":"Marcucci","year":"2023","journal-title":"Lancet Neurol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1001\/jamacardio.2016.4792","article-title":"Perioperative Major adverse cardiovascular and cerebrovascular events associated with noncardiac surgery","volume":"2","author":"Smilowitz","year":"2017","journal-title":"JAMA Cardiol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1135","DOI":"10.1016\/j.athoracsur.2013.12.032","article-title":"Prediction of Major cardiovascular events after lung resection using a modified scoring system","volume":"97","author":"Ferguson","year":"2014","journal-title":"Ann Thorac Surg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1043","DOI":"10.1161\/01.CIR.100.10.1043","article-title":"Derivation and prospective validation of a simple Index for prediction of cardiac risk of major noncardiac surgery","volume":"100","author":"Lee","year":"1999","journal-title":"Circulation"},{"key":"B5","doi-asserted-by":"publisher","first-page":"879","DOI":"10.1093\/bja\/aer268","article-title":"Incidence and predictors of major perioperative adverse cardiac and cerebrovascular events in non-cardiac surgery","volume":"107","author":"Sabat\u00e9","year":"2011","journal-title":"Br J Anaesth"},{"key":"B6","doi-asserted-by":"publisher","first-page":"936","DOI":"10.1016\/j.athoracsur.2010.05.014","article-title":"Systematic classification of morbidity and mortality after thoracic surgery","volume":"90","author":"Seely","year":"2010","journal-title":"Ann Thorac Surg"},{"key":"B7","doi-asserted-by":"publisher","first-page":"694","DOI":"10.1016\/s1010-7940(01)00875-2","article-title":"Outcome after lung cancer surgery. Factors predicting early mortality and major morbidity","volume":"20","author":"Myrdal","year":"2001","journal-title":"Eur J Cardio-Thorac Surg Off J Eur Assoc Cardio-Thorac Surg"},{"key":"B8","doi-asserted-by":"publisher","first-page":"e006648","DOI":"10.1161\/JAHA.117.006648","article-title":"Derivation and validation of a geriatric-sensitive perioperative cardiac risk Index","volume":"6","author":"Alrezk","year":"2017","journal-title":"J Am Heart Assoc"},{"key":"B9","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1016\/j.athoracsur.2025.01.010","article-title":"The society of thoracic surgeons general thoracic surgery database: 2024 update on outcomes and research","volume":"119","author":"Towe","year":"2025","journal-title":"Ann Thorac Surg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1016\/j.jamcollsurg.2013.07.385","article-title":"Development and evaluation of the universal ACS NSQIP surgical risk calculator: a decision aid and informed consent tool for patients and surgeons","volume":"217","author":"Bilimoria","year":"2013","journal-title":"J Am Coll Surg"},{"key":"B11","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1016\/j.jamcollsurg.2013.02.027","article-title":"Optimizing ACS NSQIP modeling for evaluation of surgical quality and risk: patient risk adjustment, procedure mix adjustment, shrinkage adjustment, and surgical focus","volume":"217","author":"Cohen","year":"2013","journal-title":"J Am Coll Surg"},{"key":"B12","doi-asserted-by":"publisher","first-page":"3067","DOI":"10.1016\/j.jacc.2019.04.023","article-title":"A new Index for Pre-operative cardiovascular evaluation","volume":"73","author":"Dakik","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1161\/CIRCULATIONAHA.110.015701","article-title":"Development and validation of a risk calculator for prediction of cardiac risk after surgery","volume":"124","author":"Gupta","year":"2011","journal-title":"Circulation"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1774","DOI":"10.1002\/bjs.9638","article-title":"Development and validation of the surgical outcome risk tool (SORT)","volume":"101","author":"Protopapa","year":"2014","journal-title":"Br J Surg"},{"key":"B15","doi-asserted-by":"publisher","first-page":"689","DOI":"10.1038\/s41569-021-00541-4","article-title":"Global epidemiology of dyslipidaemias","volume":"18","author":"Pirillo","year":"2021","journal-title":"Nat Rev Cardiol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1293","DOI":"10.1016\/S0140-6736(23)00215-5","article-title":"Inflammation and cholesterol as predictors of cardiovascular events among patients receiving statin therapy: a collaborative analysis of three randomised trials","volume":"401","author":"Ridker","year":"2023","journal-title":"Lancet"},{"key":"B17","doi-asserted-by":"publisher","first-page":"k835","DOI":"10.1136\/bmj.k835","article-title":"Dyslipidaemia and cardiovascular risk","volume":"360","author":"Ryan","year":"2018","journal-title":"Br Med J"},{"key":"B18","doi-asserted-by":"publisher","first-page":"598","DOI":"10.1093\/ejcts\/ezr081","article-title":"Validation of a modified scoring system for cardiovascular risk associated with major lung resection","volume":"41","author":"Ferguson","year":"2012","journal-title":"Eur J Cardiothorac Surg"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1606","DOI":"10.1161\/CIR.0000000000001184","article-title":"Cardiovascular-Kidney-Metabolic health: a presidential advisory from the American Heart Association","volume":"148","author":"Ndumele","year":"2023","journal-title":"Circulation"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1858","DOI":"10.1001\/jama.2024.6892","article-title":"Prevalence of cardiovascular-kidney-metabolic syndrome stages in US adults, 2011\u22122020","volume":"331","author":"Aggarwal","year":"2024","journal-title":"JAMA"},{"key":"B21","doi-asserted-by":"publisher","first-page":"898","DOI":"10.1016\/j.jacasi.2025.04.007","article-title":"Prevalence and mortality of cardiovascular-kidney-metabolic syndrome in China","volume":"5","author":"Zheng","year":"2025","journal-title":"JACC Asia"},{"key":"B22","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1016\/j.bja.2025.10.011","article-title":"Association of the cardiovascular\u2013kidney\u2013metabolic syndrome and adverse outcomes after noncardiac surgery","volume":"136","author":"Glance","year":"2025","journal-title":"Br J Anaesth"},{"key":"B23","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1213\/ANE.0000000000006975","article-title":"Cardiovascular-Kidney-Metabolic syndrome: association with adverse events after Major noncardiac surgery","volume":"139","author":"Roth","year":"2024","journal-title":"Anesth Analg"},{"key":"B24","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1161\/CIRCULATIONAHA.123.067626","article-title":"Development and validation of the American Heart Association\u2019s PREVENT equations","volume":"149","author":"Khan","year":"2024","journal-title":"Circulation"},{"key":"B25","doi-asserted-by":"publisher","first-page":"2886","DOI":"10.1016\/j.jacc.2014.02.606","article-title":"2013 ACC\/AHA guideline on the assessment of cardiovascular risk","volume":"63","author":"Andrus","year":"2014","journal-title":"J Am Coll Cardiol"},{"key":"B26","doi-asserted-by":"publisher","first-page":"963","DOI":"10.1001\/jamainternmed.2024.1302","article-title":"Atherosclerotic cardiovascular disease risk estimates using the predicting risk of cardiovascular disease events equations","volume":"184","author":"Anderson","year":"2024","journal-title":"JAMA Intern Med"},{"key":"B27","doi-asserted-by":"publisher","first-page":"e2438311","DOI":"10.1001\/jamanetworkopen.2024.38311","article-title":"External validation of the American Heart Association PREVENT cardiovascular disease risk equations","volume":"7","author":"Scheuermann","year":"2024","journal-title":"JAMA Netw Open"},{"key":"B28","doi-asserted-by":"publisher","first-page":"6470","DOI":"10.1111\/dom.70043","article-title":"Cardiovascular disease risk estimates for primary prevention in the US prediabetes and diabetes population using the PREVENT equation","volume":"27","author":"Li","year":"2025","journal-title":"Diabetes Obes Metab"},{"key":"B29","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1053\/j.ajkd.2025.01.012","article-title":"Cardiovascular disease risk estimates in the US CKD population using the PREVENT equation","volume":"86","author":"Walther","year":"2025","journal-title":"Am J Kidney Dis Off J Natl Kidney Found"},{"key":"B30","first-page":"113","article-title":"Advancing risk prediction for cardiovascular disease: the AHA PREVENT equations","volume":"111","author":"Khan","year":"2025","journal-title":"Am Fam Physician"},{"key":"B31","doi-asserted-by":"publisher","first-page":"m441","DOI":"10.1136\/bmj.m441","article-title":"Calculating the sample size required for developing a clinical prediction model","volume":"368","author":"Riley","year":"2020","journal-title":"Br Med J"},{"key":"B32","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1186\/s12933-025-02848-9","article-title":"C-reactive protein-triglyceride glucose index in evaluating cardiovascular disease and all-cause mortality incidence among individuals across stages 0\u22123 of cardiovascular-kidney-metabolic syndrome: a nationwide prospective cohort study","volume":"24","author":"Ou","year":"2025","journal-title":"Cardiovasc Diabetol"},{"key":"B33","doi-asserted-by":"publisher","first-page":"2591","DOI":"10.1001\/jama.291.21.2591","article-title":"Predictive value for the Chinese population of the framingham CHD risk assessment tool compared with the Chinese multi-provincial cohort study","volume":"291","author":"Liu","year":"2004","journal-title":"JAMA"},{"key":"B34","doi-asserted-by":"publisher","first-page":"e351","DOI":"10.1161\/CIR.0000000000001285","article-title":"2024 AHA\/ACC\/ACS\/ASNC\/HRS\/SCA\/SCCT\/SCMR\/SVM guideline for perioperative cardiovascular management for noncardiac surgery: a report of the American College of Cardiology\/American Heart Association joint committee on clinical practice guidelines","volume":"150","author":"Thompson","year":"2024","journal-title":"Circulation"},{"key":"B35","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1016\/j.cjca.2021.02.009","article-title":"Cardiovascular risk factors and prevention: a perspective from developing countries","volume":"37","author":"Teo","year":"2021","journal-title":"Can J Cardiol"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2026.1823917\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T13:57:38Z","timestamp":1782914258000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2026.1823917\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,1]]},"references-count":35,"alternative-id":["10.3389\/fcvm.2026.1823917"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2026.1823917","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,1]]},"article-number":"1823917"}}