Key result
Integrating hs-CRP into global ASCVD risk assessment resulted in the net reclassification of 25% of subjects, predominantly from moderate to high risk.
Why the study?
Determinants of serum hs-CRP level in pilots and air traffic controllers and its impact on their atherosclerotic cardiovascular disease risk were assessed.
Does the integration of hs-CRP improve global ASCVD risk stratification in pilots and air traffic controllers?
Cross-Sectional (n=335)
Does the integration of hs-CRP improve global ASCVD risk stratification in pilots and air traffic controllers?
The integration of hs-CRP into standard risk assessment models reclassifies a significant proportion of pilots and air traffic controllers, primarily from moderate to high ASCVD risk.
Answers are grounded in this paper and cite their sources.
Supports hs-CRP evaluation for ASCVD reclassification in aviators; leaves open prospective outcome validation before practice change.
INTRODUCTION: We assessed determinants of serum hs-CRP level in pilots and air traffic controllers (ATCs) and its impact on their atherosclerotic cardiovascular disease (ASCVD) risk. METHODS: We obtained serum hs-CRP measurements, evaluated traditional cardiovascular risk factors and assessed global ASCVD risk based on 2018 ESH/ESC guidelines. Elevated hs-CRP was hs-CRP values > 3 mg L 1 . Determinants of elevated hs-CRP were assessed using stepwise logistic regression analysis. We used the net reclassification method to evaluate the impact of hs-CRP levels on global ASCVD risk. RESULTS: Of the 335 subjects (mean age 45.4 11.6 yr, 70% pilots, 99% men, 37% Caucasians), 127 individuals (39.5%) presented with elevated hs-CRP levels. Compared to those with normal hs-CRP, individuals with elevated hs-CRP were older with faster heart rate and higher blood pressure, BMI, and P wave amplitude. The proportion of individuals with elevated hs-CRP was greater among those with smoking habits, physical inactivity, MetS, tachycardia, altered P wave axis, LVH, and HT-TOD. Aging (aOR 2.15 [1.676.98]), hypertension (aOR 3.88 [2.296.58]), type 2 diabetes (aOR 6.71 [1.7710.49]), tachycardia (aOR 2.03 [1.914.53]), and LVH (aOR 2.13 [1.647.11]) were the main factors associated with elevated hs-CRP levels. Low, moderate, high, and very high risk were observed in 24 (15%), 68 (41%), 62 (37%), and 12 (7%) subjects, respectively. Including hs-CRP resulted in the net reclassification of 25% of subjects, mostly from moderate to high risk. CONCLUSION: The integration of hs-CRP improved the estimation of global ASCVD risk stratification. However, a survey with a comprehensive population assessing the cost/benefit impact of such a referral is needed. Buila NB, Ntambwe ML, Mupepe DM, Lubenga YN, Bantu J-MB, Mvunzi TS, Kabanda GK, Lepira FB, Kayembe PK, Ditu SM, MBuyamba-Kabangu J-R. The impact of hs-CRP on cardiovascular risk stratification in pilots and air traffic controllers. Aerosp Med Hum Perform. 2020; 91(11):886891.
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Buila et al. (2020) conducted a cross-sectional in Atherosclerotic cardiovascular disease (ASCVD) risk (n=335). Serum hs-CRP measurement vs. Standard ASCVD risk assessment without hs-CRP was evaluated on Net reclassification of global ASCVD risk. Integrating hs-CRP into global ASCVD risk assessment resulted in the net reclassification of 25% of subjects, predominantly from moderate to high risk.
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