Prevention & lipidsSecondary analysis

Identifying Risk-De-Escalating Markers in PREVENT-Defined Intermediate-Risk Older Adults: Insights From ASPREE

Circ Popul Health OutcomesPublished

  • post hoc analysis

Authors' conclusion

Adding polygenic risk for coronary artery disease to the PREVENT equations may further personalize risk estimates and support clinical decision-making for older adults at intermediate risk for ASCVD events.

Study context

Population
Intermediate-risk older adults aged ≥70 years (10-year PREVENT-estimated atherosclerotic cardiovascular disease (ASCVD) risk, 7.5% to 20%) from ASPREE, a randomized trial of low-dose aspirin versus placebo in healthy older adults free of prior cardiovascular events at enrollmentparticipants included, 725 (9.3%) experienced ASCVD events
Participants
7,764 adults
Comparison
Each marker relative to a baseline model incorporating variables included in the PREVENT equation

Primary result

As reported in the abstract

ASCVD events · median follow-up of 10.3 years

participants experiencing ASCVD events

725 participants (9.3%)

Further findings

OutcomeΔCP value
Reclassification performance of Q1 polygenic risk for coronary artery disease · most powerful marker for down-grading risk+1.44%P = 0.004
Reclassification performance of Q1 hs-TnI · second-best performance+0.71%
Reclassification performance of Q1 polygenic risk for coronary artery disease — risk reduction
37%
Reclassification performance of Q1 polygenic risk for coronary artery disease — diagnostic likelihood ratio
0.627
Reclassification performance of Q1 polygenic risk for coronary artery disease — nonevents correctly reclassified downward
25.9%
Reclassification performance of Q1 polygenic risk for coronary artery disease — net reclassification index
0.101
Reclassification performance of Q1 hs-TnI — diagnostic likelihood ratio
0.727
Reclassification performance of Q1 hs-TnI — net reclassification index
0.075

Original publication

Identifying Risk-De-Escalating Markers in PREVENT-Defined Intermediate-Risk Older Adults: Insights From ASPREE. Circ Popul Health Outcomes. Published 2 July 2026. doi:10.1161/circoutcomes.126.013687

Summarised from the published abstract; every number is checked against it