To evaluate the added value of psychological factors, specifically depression, anxiety, and insomnia, on top of the SMART2 model for estimating 10-year risk of recurrent cardiovascular events in patients with atherosclerotic cardiovascular disease.
Key Findings:
Psychological factors were present in 3–9% (diagnosis), 3–45% (self-reported symptoms), and 10–14% (prescribed treatment) of patients.
No psychological factors significantly associated with recurrent CV events beyond SMART2.
C-statistics for patients with psychological factors were adequate (0.61–0.70), but not statistically significant.
Minimal added value of psychological factors was observed, with ΔC-statistic ranging from -0.0003 to 0.0011.
Interpretation:
The SMART2 model reliably estimates recurrent CV event risk in patients with psychological factors, indicating that integrating these factors does not enhance risk prediction, which has implications for clinical practice.
Limitations:
The study may not account for all psychological factors or their severity.
Findings are based on self-reported data, which may introduce bias and affect the reliability of the results.
Conclusion:
The SMART2 model provides a reliable risk assessment for patients with atherosclerotic cardiovascular disease, regardless of the presence of psychological conditions, and does not require adjustment for psychological factors. These findings suggest areas for future research.
by Joris Holtrop, Mari Nordbø Gynnild, Toril Dammen, Håvard Dalen, Ingvild Saltvedt, Hanne Ellekjær, Steven H J Hageman, Frank L J Visseren, John William McEvoy, Jannick A N Dorresteijn, John Munkhaugen, On behalf of the UCC-SMART study group
Patients are mining Reddit and TikTok for symptom intel while you're not — and a small study calls it epistemic injustice. Different knowledge, mutually unrecognized. Maybe ask where they've been reading before you wave it off as anecdote.
