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Journal of Cardiovascular Translational Research

, Volume 11, Issue 6, pp 495–502 | Cite as

A Simple Modified Framingham Scoring System to Predict Obstructive Coronary Artery Disease

  • Yong Liu
  • Qiang Li
  • Shiqun Chen
  • Xia Wang
  • Yingling Zhou
  • Ning Tan
  • Jiyan Chen
Original Article
  • 49 Downloads

Abstract

Development of simple non-invasive risk prediction model would help in early prediction of coronary artery disease (CAD) reducing the burden on public health. This paper demonstrates a risk prediction scoring system to predict obstructive coronary artery disease (OCAD) in CAD patients. A total of 13,082 patients, referred for coronary angiography (CAG) in TRUST trial, were included in the development of a multivariable diagnostic prediction model. External validation of the model used 1009 patients from PRECOMIN study. The occurrence of OCAD was observed in 73.1% and 75.1% patients in TRUST (development) and PRECOMIN study (validation) cohorts, respectively. Good discrimination and calibration were obtained in both development and validation datasets (C-statistics 0.686 and 0.677; Hosmer–Lemeshow χ2 = 5.19, p = 0.74 and χ2 = 8.60, p = 0.38, respectively). The simple risk prediction model and risk scoring system developed on the basis of routine clinical variables showed good performance for estimation of OCAD in relative high-risk patients with suspected CAD.

Keywords

Prediction model Risk factors Coronary artery disease China Validation 

Abbreviations

AUC

Area under the curve

BMI

Body mass index

CAD

Coronary artery disease

CAG

Coronary angiography

CMCS

Chinese Multi-Provincial Cohort study

CV

Cardiovascular

CVD

Cardiovascular diseases

ChiECRCT

Chinese ethics committee of registering clinical trials

DBP

Diastolic blood pressure

DM

Diabetes mellitus

FCS

Fully conditional specification

FH

Family history

FHCAD

Family history of CAD

FRS

Framingham risk score

HDL-C

High-density lipoproteins cholesterol

HT

Hypertension

LDL-C

Low-density lipoproteins cholesterol

LMIC

Low- and middle-income countries

LVEF

Left ventricular ejection fraction

MCMC

Markov Chain Monte Carlo

MI

Myocardial infarction

MPI

Multiple imputation

OCAD

Obstructive coronary artery disease

OR

Odds ratio

PCI

Percutaneous coronary intervention

PRECOMIN

Predictive value of contrast volume to creatinine clearance ratio

ROC

Receiver-operating characteristic

SBP

Systolic blood pressure

TC

Total cholesterol

TRUST

The Safety and Tolerability of Ultravist in Patients Undergoing Cardiac Catheterization

Notes

Acknowledgements

The authors acknowledge Dr. Priyanka Nair and Dr. Anuradha Nalli from Indegene Pvt. Ltd. for medical writing assistance during the development of this manuscript.

Authors’ Contributions

SC, YL, JC, and QL: conception or design of the work; SC, YL, QL and XW: acquisition, analysis, or interpretation of data. SC, YL, QL, and XW: drafting the work or revising it critically for important intellectual content. SC, YL, XW, YZ, QG, JC, QL, and NT: final approval of the version published. All authors agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Funding

The development of this manuscript was funded by Bayer. This work was supported by the Guangdong Provincial Cardiovascular Clinical Medicine Research Fund (grant number 2009X41 to Y.L. and N.T.), Science and Technology Planning Project of Guangdong Province (PRECOMIN study by Y.L. in 2011 and the study grant number 2014B070706010 to JY.C.), and the Guangdong Cardiovascular Institute and Cardiovascular Research Foundation Project of Chinese Medical Doctor Association (grant number SCRFCMDA201216 to JY.C.).

Compliance with Ethical Standards

Ethics Approval and Consent to Participate

The TRUST study (NCT01206257) and PRECOMIN study (NCT01400295) conformed to the principles of Declaration of Helsinki and were approved by the Chinese ethics committee of registering clinical trials (ChiECRCT) as the leading ethics board and additionally by the local ethics boards of each participating center. All patients gave their written informed consent prior to enrollment.

Consent for Publication

Not applicable.

Conflict of Interest

The authors declare that they have no competing interests.

Supplementary material

12265_2018_9837_MOESM1_ESM.docx (27 kb)
ESM 1 (DOCX 27 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Yong Liu
    • 1
    • 2
  • Qiang Li
    • 2
  • Shiqun Chen
    • 2
    • 3
  • Xia Wang
    • 2
  • Yingling Zhou
    • 1
    • 3
  • Ning Tan
    • 1
  • Jiyan Chen
    • 1
  1. 1.Department of Cardiology, Provincial Key Laboratory of Coronary Heart Disease, Guangdong Cardiovascular Institute, Guangdong General HospitalGuangdong Academy of Medical SciencesGuangzhouChina
  2. 2.The George Institute for Global HealthThe University of New South WalesSydneyAustralia
  3. 3.Department of Cardiology, Guangdong General Hospital Zhuhai HospitalZhuhai Golden Bay Center HospitalZhuhaiChina

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