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Comparison of MESA of and Framingham risk scores in the prediction of coronary artery disease severity

Vergleich der MESA- und Framingham-Risikoscores zur Prädiktion des Schweregrads einer koronaren Herzkrankheit

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Abstract

Background

The correlation between cardiovascular risk scoring systems and the severity of coronary artery diseases (CAD) is not clear. The present research aimed to evaluate the Multi-Ethnic Study of Atherosclerosis (MESA) risk score and Framingham risk score (FRS), using the Gensini score (GS) system as reference, so as to determine which model is better for the prediction of CAD severity.

Methods

This research was a single-center and cross-sectional observational study. In total, 1423 patients were included in our study. Three different groups were formed according to GS: 0 < GS ≤ 22 (low GS group, n = 484); 22 < GS ≤ 42 (intermediate GS group, n = 468); GS > 42 (high GS group, n = 471). Logistic and linear regression analyses were carried out to explore the relationship between the risk score models and the GS. The performance of the risk models was determined by receiver operating characteristic curve (ROC) analysis.

Results

The MESA risk score and the FRS both had a statistically significant power for the prediction of CAD severity (MESA area under curve: 0.630; FRS area under curve: 0.613). Furthermore, the MESA had a better performance in predicting the severity (p < 0.05) of CAD compared with the FRS. In the subgroup analysis, the MESA showed a better performance in the male (p < 0.05), diabetes mellitus (p < 0.05), and smoking subgroups (p < 0.05) compared with the FRS.

Conclusion

The MESA and FRS predicted the severity of CAD in the Chinese population of this study. Moreover, the MESA had a better performance than the FRS model in predicting the severity of CAD in the overall population as well as in the male, smoking, diabetes, and non-diabetes subgroups.

Zusammenfassung

Hintergrund

Die Korrelation zwischen kardiovaskulären Risikobewertungssystemen und dem Schweregrad einer koronaren Herzkrankheit (KHK) ist unklar. Ziel dieser Studie war es, den Risikoscore der Multi-Ethnic Study of Atherosclerosis (MESA) und den Framingham-Risikoscore (FRS) unter Einsatz des Gensini-Scores (GS) als Referenz zu untersuchen, um zu ermitteln, welches Modell sich besser zur Prädiktion des KHK-Schweregrads eignet.

Methoden

Es handelte sich um eine Einzelzentrum-Beobachtungsstudie im Querschnittdesign. In die Studie wurden 1423 Patienten einbezogen. Gemäß GS wurden 3 verschiedene Gruppen gebildet: 0 < GS ≤ 22 (Gruppe mit niedrigem GS, n = 484); 22 < GS ≤ 42 (Gruppe mit mittlerem GS, n = 468); GS > 42 (Gruppe mit hohem GS, n = 471). Logistische und lineare Regressionsanalysen erfolgten, um den Zusammenhang zwischen den Risikoscore-Modellen und dem GS zu untersuchen. Die Leistungsstärke der Risikomodelle wurde anhand der Receiver-Operating-Characteristic-Curve(ROC)-Analyse beurteilt.

Ergebnisse

Der MESA-Risikoscore und der FRS wiesen beide eine statistisch signifikante Power für die Prädiktion des KHK-Schweregrads auf (Fläche unter der Kurve, AUC, für MESA: 0,630; AUC für FRS: 0,613). Außerdem zeigte sich beim MESA eine bessere Leistungsstärke zur Vorhersage des Schweregrads einer KHK (p < 0,05) als bei dem FRS. In der Subgruppenanalyse war die Leistungsstärke des MESA in Bezug auf die Subgruppen Männer (p < 0,05), Diabetes-mellitus-Patienten (p < 0,05) und Raucher (p < 0,05) besser als der FRS.

Schlussfolgerung

Sowohl mit dem MESA als auch mit dem FRS ließ sich der Schweregrad einer KHK in der chinesischen Population dieser Studie vorhersagen. Darüber hinaus ergab sich für den MESA eine bessere Leistungsstärke als für das FRS-Modell hinsichtlich der Vorhersage des Schweregrads einer KHK in der Gesamtpopulation sowie bei den Subgruppen Männer, Raucher, Diabetespatienten und Personen ohne Diabetes.

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Acknowledgements

First and foremost, I would like to show my deepest gratitude to my supervisors, Dr. Fu and Dr. Zhang, respectable, responsible, and resourceful scholars, who have provided me with valuable guidance in every stage of writing this article. My sincere appreciation also goes to my colleagues, Heng Wu MD, Xulin Hong MD, Chunxia Gu MD, and Qingbo Lv MD; without their help and encouragement, this article would not be completed. Finally, thanks to those l love and those who love me.

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Authors and Affiliations

  1. Department of Cardiology, Key Laboratory of Biotherapy of Zhejiang Province, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qingchun Road, 310016, Hangzhou, Zhejiang Province, China

    Y. Wang M.D.,  Q. Lv M.D., H. Wu M.D., K. Chen M.D., X. Hong M.D., C. Gu M.D.,  G. Fu Ph.D. M.D. &  W. Zhang Ph.D. M.D.

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  1. Y. Wang M.D.
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  2. Q. Lv M.D.
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  3. H. Wu M.D.
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  4. K. Chen M.D.
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  5. X. Hong M.D.
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  6. C. Gu M.D.
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Correspondence to G. Fu Ph.D. M.D. or W. Zhang Ph.D. M.D..

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Conflict of interest

Y. Wang, Q. Lv, H. Wu, K. Chen, X. Hong, C. Gu, G. Fu, and W. Zhang declare that they have no competing interests.

All studies performed were in accordance with the ethical standards indicated in each case. All the study protocols were in accordance with the Declaration of Helsinki. All patients provided written informed consent.

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Y. Wang and Q. Lv contributed equally to this article.

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Wang, Y., Lv, Q., Wu, H. et al. Comparison of MESA of and Framingham risk scores in the prediction of coronary artery disease severity. Herz 45 (Suppl 1), 139–144 (2020). https://doi.org/10.1007/s00059-019-4838-z

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  • DOI: https://doi.org/10.1007/s00059-019-4838-z

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