Enhanced prediction of the population at risk of atherothrombotic disease

Enhanced prediction of the population at risk of atherothrombotic disease

Annual Conference on HEART DISEASES
September 18-19, 2017 | Toronto, Canada

William E Feeman

Bowling Green Study, USA

Abstract:

Introduction: The holy grail of the prevention of atherothrombotic disease (ATD) lies with the prediction of the population at risk of ATD. Many different risk predictors have been advocated, but none universally accepted. The author presents his risk predictor based on the characteristics of those who have developed some form of clinical ATD during the 4November 1974-4November2003 time frame. Purpose: Following the precepts of the Framingham Heart Study, the author has analyzed the constellation of ATD risk factors that characterize the ATD population and has generated a predictive tool that accurately characterizes that population. Methods: The author has examined his patient population database and separated out those who developed some form of clinical ATD during the study timeframe, compared with those who did not. Results: The population who developed ATD is characterized by cigarette smoking, dyslipidemia, and (often) hypertension, with some contribution from uncontrolled diabetes. ATD patients are defined by an abnormal lipid ratio, as defined by the Cholesterol Retention Fraction (CRF, defined as [LDL-HDL]/LDL) with/without cigarette smoking and/or hypertension. This is best seen in a risk factor graph with the CRF on the ordinate and systolic blood pressure (SBP). The graph is characterized by a threshold line with CRF-SBP co-ordinates (0,74,100) and (0.49,140), above which lie the CRF-SBP plots of 93% of all of the ATD patients (710 patients) in the author’s practice (See Figure.1). Fine tuning of risk prediction is done by stratification by cigarette smoking status, and the outcomes of the ATD patients are given in Table I. Additional risk stratification is done by stratifying CRF vs SBP and CRF by LDL-cholesterol. Any therapy that brings the CRF-SBP plot below the threshold line results in plaque stabilization/regression in a minimum average of 76% of cases. Conclusions: The population at risk of ATD is predictable and hence preventable.

Biography:

William E. Feeman Jr., MD, is a Physician on staff at Wood County Hospital, and in private practice, both in Bowling Green, Ohio. He attended undergraduate school at Ohio State University (1961-1966) and became interested in a career in medicine during that time; prior to his decision to enter medicine he planned to have a career in astronomy. He attended undergraduate medical school at Ohio State University, earning Bachelor of Science in physiology (1961-1966) and medical school at Ohio State University (19661970); where he developed an interest in the primary and secondary prevention of atherothrombotic disease. Over the last 26 plus years, he has spent his professional life in medicine perfecting a tool to predict the population at risk of atherothrombotic disease e and to guide therapy to maximally stabilize/reverse that disease if extant. Thus he has founded the Bowling Green Study of the Primary and Secondary Prevention of Atherothrombotic Disease (BGS) to which he is the principal investigator. This study terminated on 4 November 2003. Dr. Feeman has had six major articles published in various science/medical journal. He has had numerous letters to the editor published in various medical journals. All publications relate to the primary and second prevention of atherothromboitc disease. He has presented data at a number of annual scientific assemblies of the American Academy of Family Physicians and at a number of national and international symposia in atherothrombotic disease. Dr. Feeman is the founder of the Association for the Prevention of Atherothrombotic Disease in Northwest Ohio to facilitate the spread of knowledge about this disease.

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