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The design and rationale of SAVE BC: The Study to Avoid CardioVascular Events in British Columbia
Liam R Brunham1,2, Kelsey Lynch2, Amy English2
1Department of Medicine, University of British Columbia, Vancouver, Canada.
Insights
Screening for premature atherosclerotic cardiovascular disease (ASCVD) in relatives can identify at-risk individuals. The SAVE BC study evaluates a structured screening program to improve early detection and prevention of ASCVD.
Area of Science:
- Cardiology
- Genetics
- Preventive Medicine
Background:
- Atherosclerotic cardiovascular disease (ASCVD) has a strong genetic component, especially in premature cases.
- Routine screening for premature ASCVD and its genetic predisposition is not standard practice.
- There is a need for effective strategies to identify individuals at high risk for early-onset ASCVD.
Purpose of the Study:
- To evaluate the effectiveness of a structured screening program for identifying individuals at risk of premature ASCVD.
- To determine the diagnostic yield of screening first-degree relatives (FDRs) and spouses of index cases with very premature ASCVD.
- To longitudinally follow individuals identified through screening for cardiovascular risk factors and events.
Main Methods:
- Prospective, observational design of the Study to Avoid CardioVascular Events in British Columbia (SAVE BC).
- Inclusion of individuals with very premature ASCVD (males ≤50 years, females ≤55 years) and their FDRs and spouses.
- Application of a structured screening algorithm for cardiovascular risk factors and subclinical ASCVD in FDRs and spouses.
- Longitudinal follow-up of all subjects for at least 10 years.
Main Results:
- Data collection on cardiovascular risk factors, medication use, cardiovascular events, and healthcare costs.
- Analysis of the diagnostic yield of the structured screening program.
- Identification of individuals with high risk for premature ASCVD.
Conclusions:
- The SAVE BC study aims to provide insights into identifying individuals at risk for premature ASCVD.
- Findings will inform prevention and treatment strategies for individuals and families affected by early-onset ASCVD.
- Structured screening programs hold potential for improving early detection and management of heritable cardiovascular disease.
Abstract:
Atherosclerotic cardiovascular disease (ASCVD) is highly heritable, particularly when it occurs at a young age. The screening of individuals with premature ASCVD, although often recommended, is not routinely performed. Strategies to address this gap in care are essential. We designed the Study to Avoid CardioVascular Events in British Columbia (SAVE BC) as a prospective, observational study of individuals with a new diagnosis of very premature ASCVD (defined as age ≤ 50 years in males and age ≤ 55 years in females) and their first-degree relatives (FDRs) and spouses. FDRs and spouses will undergo screening for cardiovascular (CV) risk factors and subclinical ASCVD using a structured screening algorithm. All subjects will be followed longitudinally for ≥10 years. The overall goal of SAVE BC is to evaluate the yield of a structured screening program for identifying individuals at risk of premature ASCVD. The primary objectives of SAVE BC are to identify and follow index cases with very premature ASCVD and their FDRs and to determine the diagnostic yield of a structured screening program for these individuals. We will collect data on CV risk factors, medication use, CV events, and healthcare costs in these individuals. SAVE BC will provide insight regarding approaches to identify individuals at risk for premature ASCVD with implications for prevention and treatment in this population.
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