Risk markers

Question 1

It remains the leading preventable cause of death and disease; and the single most important risk factor for CAD

Answer 1

Smoking

Question 2

Smoking cessation reduces the risk of coranary event by how many percent within the first 2 years?

Answer 2

50%

Question 3

Which of the ff is/are true re: NRT except

1. No overall diffrences in effectiveness between different forms of NRT
2. NRT was effective with or w/o counseling
3. NRT + bupropion was more effective than bupropion alone
4. No evidence that NRT increased risk of heart attacks

Answer 3

None of the above

Question 4

It is the major risk factor for CHD, heart failure, CVD, PAD, Renal Failure, AF and total mortality

Answer 4

Hypertension

Question 5

Prehypertension* BP range ?

*associated with almost 2x the risk of MI amd stroke in WOMEN compared with normal BP

Answer 5

SBP 120-139mmHg

DBP 80-89mmHg

Question 6

This measurement predict CV events independently and provides prognostic utility beyond the MAP

Answer 6

Pulse pressure*

Defined as the difference between SBP and DBP

Question 7

This measurement provide a stronger predictor of CV morbidity and mortality than office-based measures

Answer 7

24h ABPM

Question 8

This trial randomly assigned non-diabetics with vascular risk and BP > 130mmHg to a target BP < 120 and < 140mmg. the study was halted due to 25% reduction in MACE in 120mmHg group and 27% reduction in all cause mortality

Answer 8

SPRINT - Systolic Blood Pressure Intervention Trial

Question 9

This trial evaluated the potential benefit of < 120 vs <140mmHg among DM patients

Answer 9

ACCORD - Action to Control Cardiovascular risk in Diabetes

Question 10

This trial enrolled internediate risk without known CVD allocated to a combination candesartan 16mg + HCTZ OR to a placebo.

Answer 10

HOPE-3
Heart outcomes Prevention Evaluation 3

Result: No significant effect on primary outcomes, but for BP (>143.5mmHg) had a significant reduction on vascular events

Question 11

It is the best-established risk factor causally linked to incident MI and CV death.

Answer 11

LDL

Question 12

This trial demonstrated ~50% reduction in MI and stroke with rosuvastatin

Answer 12

JUPITER trial

Question 13

This trial affirmed the concept of “lower is better”, where the addition of ezetimibe to statin therapy alone further modestly reduced LDLC, hsCRP and vascular events

Answer 13

IMROVE IT trial

Question 14

PCSK9 inhibitor in FOURIER trial

Answer 14

Evolocumab

Question 15

These trials randomly allocated high risk patients to niacin supplementation to increase HDL but showed no beneficial effects at all on clinical events

Answer 15

AIM- HIGH and HPS-Thrive trials

Question 16

This trial used fenofibrate to reduce TGL and increase HDL but showed no significant reduction in vascular events

Answer 16

ACCORD trial

Question 17

This trial showed an increased all cause mortality with CETP inhibitor, torcetrapib

Answer 17

ILLUMINATE trial

Question 18

Key regulator of TG concentrations in blood

Answer 18

Lipoprotein lipase

Question 19

Define metabolic syndrome

Answer 19

A cluster of glucose intolerance and hyperinsulinemia accompanied by hypertryglyceridemia, low HDL, hypofibrinolysis, hypertension, microabuminuria, predominance of small dense LDL particles and central obesity

Question 20

A medication which provides benefit for persons at high risk for subsequent events 2 to existing CVD

Answer 20

Low-dose aspirin

• No clear net benefit of low dose aspirin in PRIMARY PREVENTION of CVD
• DM in itself DOES NOT qualify inviduals for aspirin therapy except for patients > 50 yo + 1 additional major CVD risk factor

Question 21

A sulfhydryl containing amino acid derived from the demethylation of dietary methionine

Answer 21

Homocysteine

Question 22

Common carotid intima thickness of what value increases future CV risk by 9%

Answer 22

0.1mm increase in CIMT thickness

Question 23

A zero coronary calcium score would entail how many percent of future vascular events

Answer 23

17%

Question 24

2 genetic markers of inflammation for CV risk

Answer 24

IL6R and CXCL12

Question 25

BMI formula

Answer 25

Weight in Kg divided by height in meters squared

Overweight BMI > 25
Obese > 30

Question 26

Habitual heavy alcohol consumption means..

Answer 26

8 or more drinks per week for women and 15 or more drinks a week for men