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Framingham risk score and severity of coronary artery disease

Framingham-Risikoscore und Schweregrad der koronaren Herzkrankheit

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Abstract

Objectives

Coronary artery disease (CAD) is a leading cause of morbidity and mortality worldwide. Easy-to-perform and reliable parameters are needed to predict the presence and severity of CAD and to implement efficient diagnostic and therapeutic modalities. We aimed to examine whether the Framingham risk scoring system can be used for this purpose.

Methods

A total of 222 patients (96 women, 126 men; mean age, 59.1 ± 11.9 years) who underwent coronary angiography were enrolled in the study. Presence of > %50 stenosis in a coronary artery was assessed as critical CAD. The Framingham risk score (FRS) was calculated for each patient. CAD severity was assessed by the Gensini score. The relationship between the FRS and the Gensini score was analyzed by correlation and regression analyses.

Results

The mean Gensini score was 18.9 ± 25.8, the median Gensini score was 7.5 (0–172), the mean FRS was 7.7 ± 4.2, and the median FRS was 7 (0–21). Correlation analysis revealed a significant relationship between FRS and Gensini score (r = 0.432, p < 0.0001). This relationship was confirmed by linear regression analysis (β = 0.341, p < 0.0001). A cut-off level of 7.5 for FRS predicted severe CAD with a sensitivity of 68 % and a specificity of 73.6 % (ROC area under curve: 0.776, 95 % CI: 0.706–0.845, PPV: 78.1 %, NPV: 62.3 %, p < 0.0001).

Conclusion

Our work suggests that the FRS system is a simple and feasible method that can be used for prediction of CAD severity. As the sample size was small in our study, further large-scale studies are needed on this subject to draw solid conclusions.

Zusammenfassung

Ziele

Die koronare Herzkrankheit (KHK) ist weltweit eine der Hauptursachen für Morbidität und Mortalität. Leicht zu erhebende und verlässliche Parameter sind erforderlich, um das Vorliegen und den Schweregrad einer KHK vorherzusagen und wirksame Diagnostik- und Therapiemodalitäten einzusetzen. Ziel war zu untersuchen, ob das System des Framingham-Risikoscores (FRS) dazu verwendet werden kann.

Methoden

In die Studie aufgenommen wurden insgesamt 222 Patienten (96 w, 126 m, Durchschnittsalter: 59,1 ± 11,9 Jahre), bei denen eine Koronarangiographie erfolgte. Das Vorliegen einer Stenose von >50 % wurde als kritische KHK beurteilt. Der FRS wurde für jeden Patienten berechnet. Der Schweregrad der KHK wurde anhand des Gensini-Scores festgelegt. Der Zusammenhang zwischen FRS und dem Gensini-Scroe wurde durch Korrelations- und Regressionsanalysen ermittelt.

Ergebnisse

Der durchschnittliche Gensini-Score betrug 18,9 ± 25,8, der Median des Gensini-Scores 7,5 (0–172); der durchschnittliche FRS lag bei 7,7 ± 4,2 und der Median des FRS bei 7 (0–21). Die Korrelationsanalyse ergab einen signifikanten Zusammenhang zwischen FRS und Gensini-Score (r = 0,432; p < 0,0001). Dieser Zusammenhang wurde mittels linearer Regressionsanalyse bestätigt (β = 0,341; p < 0,0001). Ein Grenzwert von 7,5 für den FRS sagte eine schwere KHK mit einer Sensitivität von 68 % und einer Spezifität von 73,6 % voraus (ROC, Fläche unter der Kurve: 0,776; 95 %-KI: 0,706–0,845; PPV: 78,1 %; NPV: 62,3 %; p < 0,0001).

Schlussfolgerung

Die vorliegende Studie ergibt Hinweise darauf, dass das FRS-System eine einfache und praktikable Methode ist, die zur Vorhersage des Schweregrads einer KHK verwendet werden kann. Da die Stichprobengröße der Studie klein war, sind zukünftige Studien in größerem Umfang zu diesem Thema erforderlich, um beständige Schlussfolgerungen daraus zu ziehen.

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Conflict of interest

On behalf of all authors, the corresponding author states that there are no conflicts of interest.

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Authors and Affiliations

  1. Department of Cardiology, Faculty of Medicine, Bulent Ecevit University, 67600, Kozlu/Zonguldak, Turkey

    M.R. Sayin MD, T. Karabag, I. Akpinar, S.M. Dogan & M. Aydin

  2. Department of Cardiology, Zonguldak Karadeniz Eregli State Hospital, Zonguldak, Turkey

    M.A. Cetiner

  3. Department of Public Health, Faculty of Medicine, Bulent Ecevit University, Zonguldak, Turkey

    E. Sayin & M.A. Kurcer

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  1. M.R. Sayin MD
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  2. M.A. Cetiner
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  3. T. Karabag
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Correspondence to M.R. Sayin MD.

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Sayin, M., Cetiner, M., Karabag, T. et al. Framingham risk score and severity of coronary artery disease. Herz 39, 638–643 (2014). https://doi.org/10.1007/s00059-013-3881-4

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  • DOI: https://doi.org/10.1007/s00059-013-3881-4

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