7 A Toolkit for Healthcare Professionals Frequently Asked Questions: PREVENT Equations How do the PREVENT equations differ from PCE? The PREVENT equations differ from the older PCE, which was derived from historical observational research cohorts, in numerous ways. Namely, the PREVENT equations: • Were derived and validated using data from large, contemporary and diverse datasets of more than 6.5 million adults from all over the U.S. The derivation samples included electronic medical record data from patients receiving care across multiple health systems and population-based cohorts or research studies. • Include predictors for kidney and metabolic health to support a more holistic approach for screening, assessing risk and preventing CVD among patients with or at risk for CKM syndrome.8 • Incorporate additional predictors of total CVD (a composite of ASCVD and HF), including eGFR, BMI and optional fields for UACR, HbA1c and ZIP code, which are readily available in the primary care setting and through the electronic health record, to provide a more individualized picture of CKM health and clearer insights to support long-term prevention discussions with patients. • Lower the age range to 30 to begin predicting risk in younger adults, whose short-term cardiovascular risk may be low but whose long-term risk may be higher, and to capture risk emerging earlier in the life cycle and opportunities to implement CVD prevention strategies. • Provide both a 10-year and 30-year risk percentage for CVD, ASCVD, and HF to predict a patient’s short- and long-term likelihood of developing future events. • Include lipid-lowering therapy (LLT) as a clinical data input. • Exclude race as a predictor.3 Why were race-free equations adopted in the PREVENT model? The PREVENT equations were developed with clinical and social variables that holistically capture risk of cardiovascular outcomes. Since race is a social construct, and not a biological predictor, it was not included in the PREVENT equations. The inclusion of a place-based measure of social disadvantage supports more equitable approach. The PREVENT equations demonstrate high accuracy across all racial and ethnic groups, with predicted risk closely matching observed risk, eliminating the need for racespecific equations. What if patient data, such as UACR or HbA1c, is unavailable? The base PREVENT equations may still be used for risk estimation without these optional add-ons. However, consider additional testing to acquire missing optional data, such as HbA1c and UACR, to further personalize cardiovascular risk assessment. This add-on data helps ensure that clinicians screen all eligible individuals. UACR is clinically indicated for individuals with CKD, diabetes or hypertension. HbA1c is clinically indicated for individuals with diabetes, prediabetes, overweight/obesity or a history of gestational diabetes. Are the PREVENT equations applicable to patients outside the 30 to 79 age range? The PREVENT equations are only validated for adults aged 30 to 79 years who do not have a history of CVD. If any required variable, including age, is missing or out of range,the online calculator will not generate a risk estimate. For clinicians: American Heart Association PREVENT™ Equations Frequently Asked Questions. Clinicians can access this reference for common questions about PREVENT equations eligibility, inputs and interpretation. For patients: American Heart Association PREVENT™ Frequently Asked Questions for Patients. Resources for Frequently Asked Questions for Clinicians and Patients PREVENT Equations: Frequently Asked Questions WEBINAR/TUTORIAL:
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