Table 3.
Atherosclerotic Cardiovascular Disease Event Rates and Hazard Ratios by the 2018 AHA/ACC Atherosclerotic Cardiovascular Disease Risk Categories and Estimated Glomerular Filtration Rate Levels
| Outcomes | ASCVD Risk Category |
||
|---|---|---|---|
| No History of Major ASCVD Events | History of 1 Major ASCVD Event With Multiple High-Risk Conditions | History of ≥2 Major ASCVD Events | |
| eGFR < 30 mL/min/1.73 m2 | n=279 | n=135 | n=61 |
| ASCVD events | |||
| Events/person-years | 59/2,017 | 53/718 | 22/284 |
| Unadjusted rate | 29.3 (21.8-36.7) | 73.8 (53.9-93.7) | 77.5 (53.9-93.7) |
| Adjusted rate | 38.8 (27.9-49.8) | 83.0 (59.5-106.5) | 81.8 (41.3-122.3) |
| Adjusted rate difference | 0.0 (reference) | 44.2 (18.2-70.1) | 43.0 (1.03-84.9) |
| Hazard ratio | 1.0 (reference) | 1.85 (1.26-2.72) | 1.76 (1.07-2.92) |
| Myocardial infarction | |||
| Events/person-years | 43/2,097 | 35/783 | 14/318 |
| Unadjusted rate | 20.5 (14.4-26.6) | 44.7 (29.9-59.5) | 44.0 (20.9-67.0) |
| Adjusted rate | 26.1 (17.5-34.8) | 50.9 (33.4-68.4) | 49.1 (17.6-80.6) |
| Adjusted rate difference | 0.0 (reference) | 24.8 (5.2-44.3) | 23.0 (−9.7-55.6) |
| Hazard ratio | 1.0 (reference) | 1.56 (0.98-2.49) | 1.41 (0.77-2.58) |
| Ischemic stroke | |||
| Events/person-years | 8/2,196 | 11/867 | 3/336 |
| Unadjusted rate | 3.6 (1.1-6.2) | 12.7 (5.2-20.2) | 8.9 (0.0-19.0)a |
| Adjusted rate | 5.0 (1.2-8.4) | 13.2 (5.0-21.5) | 16.7 (0.0-42.7)a |
| Adjusted rate difference | 0.0 (reference) | 8.2 (−0.9-17.3) | 11.7 (−14.6-37.9) |
| Hazard ratio | 1.0 (reference) | 2.69 (1.03-7.03) | 1.64 (0.44-6.16) |
| Peripheral artery disease | |||
| Events/person-years | 20/2,132 | 19/848 | 8/317 |
| Unadjusted rate | 9.4 (5.3-13.5) | 22.4 (12.3-32.5) | 25.2 (7.8-42.8) |
| Adjusted rate | 12.0 (6.3-17.8) | 24.6 (13.1-36.2) | 25.7 (6.7-44.8) |
| Adjusted rate difference | 0.0 (reference) | 12.6 (−0.3-25.5) | 13.7 (−6.2-33.6) |
| Hazard ratio | 1.0 (reference) | 2.07 (1.06-4.03) | 2.07 (0.87-4.95) |
| eGFR 30 to <45 mL/min/1.73 m2 | n=380 | n=169 | n=57 |
| ASCVD events | |||
| Events/person-years | 61/3,221 | 57/1,205 | 20/326 |
| Unadjusted rate | 18.9 (14.2-23.7) | 47.3 (35.0-59.6) | 61.3 (34.5-88.3) |
| Adjusted rate | 20.2 (14.9-25.4) | 50.4 (37.0-63.7) | 70.7 (37.6-103.8) |
| Adjusted rate difference | 0.0 (reference) | 30.2 (15.8-44.6) | 50.5 (17.0-84.0) |
| Hazard ratio | 1.0 (reference) | 2.18 (1.52-3.14) | 2.37 (1.40-4.02) |
| Myocardial infarction | |||
| Events/person-years | 38/3,276 | 41/1,273 | 10/374 |
| Unadjusted rate | 11.6 (7.9-15.3) | 32.2 (22.3-42.1) | 26.7 (10.2-43.3) |
| Adjusted rate | 12.9 (8.7-17.1) | 34.1 (23.5-44.7) | 28.0 (9.9-46.1) |
| Adjusted rate difference | 0.0 (reference) | 21.2 (9.8-32.6) | 15.1 (−3.5-33.7) |
| Hazard ratio | 1.0 (reference) | 2.37 (1.51-3.73) | 1.70 (0.82-3.52) |
| Ischemic stroke | |||
| Events/person-years | 21/3,369 | 13/1,349 | 5/401 |
| Unadjusted rate | 6.2 (3.6-8.9) | 9.6 (4.4-14.9) | 12.5 (1.5-23.4) |
| Adjusted rate | 6.0 (3.3-8.7) | 10.7 (4.7-16.6) | 12.2 (1.1-23.3) |
| Adjusted rate difference | 0.0 (reference) | 4.7 (−1.8-11.2) | 6.2 (−5.2-17.6) |
| Hazard ratio | 1.0 (reference) | 1.35 (0.67-2.70) | 1.49 (0.57-3.88) |
| Peripheral artery disease | |||
| Events/person-years | 11/3,379 | 19/1,342 | 7/384 |
| Unadjusted rate | 3.3 (1.3-5.2) | 14.2 (7.8-20.5) | 18.2 (4.7-31.8) |
| Adjusted rate | 3.9 (1.6-6.3) | 15.1 (8.1-22.0) | 18.4 (4.0-32.8) |
| Adjusted rate difference | 0.0 (reference) | 11.2 (3.8-18.5) | 14.5 (−0.1-29.1) |
| Hazard ratio | 1.0 (reference) | 3.87 (1.84-8.15) | 4.24 (1.60-11.20) |
| eGFR ≥45 mL/min/1.73 m2 | n=409 | n=166 | n=40 |
| ASCVD events | |||
| Events/person-years | 56/3,782 | 38/1,387 | 17/289 |
| Unadjusted rate | 14.8 (10.9-18.7) | 27.4 (18.7-36.1) | 58.8 (30.8-86.6) |
| Adjusted rate | 15.0 (10.6-19.4) | 26.6 (17.8-35.5) | 67.5 (30.8-104.1) |
| Adjusted rate difference | 0.0 (reference) | 11.6 (1.8-21.5) | 52.5 (15.6-89.4) |
| Hazard ratio | 1.0 (reference) | 1.66 (1.10-2.51) | 3.69 (2.10-6.48) |
| Myocardial infarction | |||
| Events/person-years | 36/3,867 | 25/1,448 | 7/335 |
| Unadjusted rate | 9.3 (6.3-12.4) | 17.3 (10.5-24.0) | 20.9 (5.4-36.4) |
| Adjusted rate | 10.2 (6.5-13.9) | 18.1 (10.7-25.5) | 20.7 (4.5-37.0) |
| Adjusted rate difference | 0.0 (reference) | 7.9 (−0.3-16.2) | 10.5 (−6.1-27.2) |
| Hazard ratio | 1.0 (reference) | 1.66 (0.98-2.79) | 1.98 (0.85-4.60) |
| Ischemic stroke | |||
| Events/person-years | 12/4,013 | 6/1,516 | 9/332 |
| Unadjusted rate | 3.0 (1.3-4.7) | 4.0 (0.8-7.1) | 27.1 (9.4-44.8) |
| Adjusted rate | 2.7 (1.0-4.3) | 3.6 (0.6-6.6) | 31.1 (8.0-54.2) |
| Adjusted rate difference | 0.0 (reference) | 0.9 (−2.5-4.3) | 28.4 (5.3-51.6) |
| Hazard ratio | 1.0 (reference) | 1.19 (0.46-3.13) | 8.30 (3.59-19.22) |
| Peripheral artery disease | |||
| Events/person-years | 14/3,971 | 8/1,501 | 7/338 |
| Unadjusted rate | 3.5 (1.7-9.0) | 5.3 (1.6-9.0) | 20.7 (5.4-36.0) |
| Adjusted rate | 3.5 (1.4-5.5) | 4.4 (1.3-7.4) | 25.4 (4.9-45.8) |
| Adjusted rate difference | 0.0 (reference) | 0.9 (−2.8-4.6) | 21.9 (1.3-42.5) |
| Hazard ratio | 1.0 (reference) | 1.27 (0.54-2.99) | 5.34 (2.15-13.28) |
Values between parenthesis indicate 95% CI. Rates and rate differences are expressed per 1,000 person-years. Adjusted rates were calculated using direct standardization, with the standard population being all participants with very high ASCVD risk: men <55 years (8.7%), 55 to 65 years (24.4%), 65 to 70 years (15.1%), and ≥70 years (14.2%); women <55 years (5.9%), 55 to 65 years (14.7%), 65 to 70 years (8.7%), ≥70 years (8.3%). Hazard ratios were adjusted for age and sex, and account for the competing risk of death. There were 57 participants with missing eGFR who were not included in this table. ASCVD events include myocardial infarction, ischemic stroke, or peripheral artery disease.
Abbreviations: ACC, American College of Cardiology; AHA, American Heart Association; ASCVD, atherosclerotic cardiovascular disease; CI, confidence interval; eGFR, estimated glomerular filtration rate.
A lower 95% CI <0 was calculated. However, we reported a lower 95% CI of zero instead as rates cannot be negative.