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Traditional Cardiovascular Risk Factors as Predictors of Cardiovascular Events in the U.S. Astronaut CorpsRisk prediction equations from the Framingham Heart Study are commonly used to predict the absolute risk of myocardial infarction (MI) and coronary heart disease (CHD) related death. Predicting CHD-related events in the U.S. astronaut corps presents a monumental challenge, both because astronauts tend to live healthier lifestyles and because of the unique cardiovascular stressors associated with being trained for and participating in space flight. Traditional risk factors may not hold enough predictive power to provide a useful indicator of CHD risk in this unique population. It is important to be able to identify individuals who are at higher risk for CHD-related events so that appropriate preventive care can be provided. This is of special importance when planning long duration missions since the ability to provide advanced cardiac care and perform medical evacuation is limited. The medical regimen of the astronauts follows a strict set of clinical practice guidelines in an effort to ensure the best care. The purpose of this study was to evaluate the utility of the Framingham risk score (FRS), low-density lipoprotein (LDL) and high-density lipoprotein levels, blood pressure, and resting pulse as predictors of CHD-related death and MI in the astronaut corps, using Cox regression. Of these factors, only two, LDL and pulse at selection, were predictive of CHD events (HR(95% CI)=1.12 (1.00-1.25) and HR(95% CI)=1.70 (1.05-2.75) for every 5-unit increase in LDL and pulse, respectively). Since traditional CHD risk factors may lack the specificity to predict such outcomes in astronauts, the development of a new predictive model, using additional measures such as electron-beam computed tomography and carotid intima-media thickness ultrasound, is planned for the future.
Document ID
20090035725
Acquisition Source
Johnson Space Center
Document Type
Presentation
Authors
Halm, M. K.
(NASA Johnson Space Center Houston, TX, United States)
Clark, A.
(Wyle Labs., Inc. Houston, TX, United States)
Wear, M. L.
(Wyle Labs., Inc. Houston, TX, United States)
Murray, J. D.
(Wyle Labs., Inc. Houston, TX, United States)
Polk, J. D.
(NASA Johnson Space Center Houston, TX, United States)
Amirian, E.
(Wyle Labs., Inc. Houston, TX, United States)
Date Acquired
August 24, 2013
Publication Date
December 2, 2009
Subject Category
Aerospace Medicine
Report/Patent Number
JSC-CN-18979
Meeting Information
Meeting: Kelsey Research Foundation''s Annual Health Services & Outcomes Research Conference
Location: Houston, TX
Country: United States
Start Date: December 2, 2009
Funding Number(s)
CONTRACT_GRANT: NAS9-02078
Distribution Limits
Public
Copyright
Public Use Permitted.
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