PREVENT equation accurately estimated 10-year CVD risk and those with calcium buildup
Research Highlights:
Embargoed until 4 a.m. CT/5 a.m. ET Wednesday, May 21, 2025
( NewMediaWire ) - May 21, 2025 - DALLAS — The PREVENTTM risk calculator helped to identify people with plaque buildup in the arteries of the heart, in addition to predicting their risk of a future heart attack, according to new research published today in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association.
In addition, when combining PREVENT and a coronary calcium score, risk prediction was further improved, with patients with the highest risk of heart attack matched the group of participants who had a heart attack during the follow-up period.
'These findings are important because when we can better predict a patient's risk of heart attack, we can also tailor care and determine who may benefit from treatment to prevent a heart attack, such as cholesterol-lowering medications,' said corresponding author Morgan Grams, M.D., Ph.D., the Susan and Morris Mark Professor of Medicine and Population Health at New York University's Grossman School of Medicine in New York City.
The PREVENT (Predicting Risk of cardiovascular disease EVENTs) risk calculator, released by the American Heart Association in 2023, can estimate 10-year and 30-year risk for heart attack, stroke, heart failure or all three in adults as young as age 30. PREVENT factors in age, blood pressure, cholesterol, body mass index, Type 2 diabetes status, social determinants of health, smoking and kidney function to estimate future risk of heart attack, stroke or heart failure.
One tool for screening heart health is coronary computed tomography angiography (CCTA), a non-invasive imaging test that visualizes plaque buildup in the heart's arteries. From the CCTA, patients are given a coronary artery calcium (CAC) score, which helps to inform decisions about heart disease prevention and treatment, including when it may be appropriate to prescribe cholesterol-lowering medications.
In this study, researchers investigated whether the PREVENT score matched the level of calcium buildup according to the CAC score. In addition, they used the PREVENT risk assessment and coronary artery calcium scores, separately and in combination, to predict future heart attack risk and assessed the accuracy of each with the participants who had a heart attack during the follow-up period.
They reviewed electronic health records for nearly 7,000 adults who had had CCTA screening at NYU Langone Health in New York City between 2010 and 2024.
The analysis found that for all participants:
'The findings illustrate that PREVENT is accurate in identifying people who may have subclinical risk for cardiovascular disease, meaning blocked arteries before symptoms develop,' said Grams. 'This study used a real-world set of patients, so our findings are important in shaping future guidelines on the use of the PREVENT calculator and coronary computed tomography angiography.'
Study co-author and American Heart Association volunteer expert Sadiya Khan, M.D., MSc., FAHA, said the CAC score can help classify risk for heart disease by analyzing calcium buildup.
'CT scans to evaluate for coronary calcium and extent of coronary artery calcium buildup may be useful when patients are uncertain if they want to start lipid-lowering therapy or if lipid-lowering therapy should be intensified. We have so many tools in our armamentarium for reducing risk of heart attack, we want to be able to optimize treatments for patients, and especially those with higher risk,' said Khan, who chaired the writing group for the Association's 2023 Scientific Statement announcing PREVENT, Novel Prediction Equations for Absolute Risk Assessment of Total Cardiovascular Disease Incorporating Cardiovascular-Kidney-Metabolic Health.
Study details, background and design:
The study had several limitations, including that patients were screened at a single institution and the majority of participants were noted as white, so the findings may not be generalizable to other people. The analysis only included people who had undergone coronary calcium screening, and electronic health records were the sole source of data. In addition, the follow-up time was short at 1.2 years, and the presence of non-calcified plaque in the heart's arteries was not assessed. Finally, the study may overestimate the prevalence of coronary artery calcium in low-risk people since participants in this study were referred for CCTA/CAC score by a health care professional, which means they may have more heart disease risk factors than the general population.
Co-authors, disclosures and funding sources are listed in the manuscript.
Studies published in the American Heart Association's scientific journals are peer-reviewed. The statements and conclusions in each manuscript are solely those of the study authors and do not necessarily reflect the Association's policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives more than 85% of its revenue from sources other than corporations. These sources include contributions from individuals, foundations and estates, as well as investment earnings and revenue from the sale of our educational materials. Corporations (including pharmaceutical, device manufacturers and other companies) also make donations to the Association. The Association has strict policies to prevent any donations from influencing its science content. Overall financial information is available here.
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About the American Heart Association
The American Heart Association is a relentless force for a world of longer, healthier lives. Dedicated to ensuring equitable health in all communities, the organization has been a leading source of health information for more than one hundred years. Supported by more than 35 million volunteers globally, we fund groundbreaking research, advocate for the public's health, and provide critical resources to save and improve lives affected by cardiovascular disease and stroke. By driving breakthroughs and implementing proven solutions in science, policy, and care, we work tirelessly to advance health and transform lives every day. Connect with us on heart.org, Facebook, X or by calling 1-800-AHA-USA1.
For Media Inquiries and AHA/ASA Expert Perspective: 214-706-1173
Bridgette McNeill: [email protected]
For Public Inquiries: 1-800-AHA-USA1 (242-8721)
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