scholarly journals Improving the predictive capability of Framingham Risk Score for risk of myocardial infarction based on coronary artery calcium score in healthy Singaporeans

2021 ◽  
Author(s):  
CYI Yeo ◽  
JC Jr Allen ◽  
W Huang ◽  
WY Tan ◽  
SC Kong ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Risk Prediction ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Agatston Score ◽  
Activity Levels ◽  
Data Types ◽  
Cvd Risk ◽  
Objective Health ◽  
Framingham Risk

Introduction: Cardiovascular disease emerged as the top cause of deaths and disability in Singapore in 2018, contributing extensively to the local healthcare burden. Primary prevention identifies at-risk individuals for the swift implementation of prevention or corrective measures. This has been traditionally done using the Singapore-adapted Framingham Risk Score (SG FRS). However, its most recent recalibration was done more than a decade ago. Recent changes in patient demographics and risk factors have undermined the accuracy of SG FRS, and the rising popularity of wearable health metrics have given rise to new data types with the potential to improve risk prediction. Methods: In healthy Singaporeans enrolled in the SingHEART study (in the absence of any clinical outcomes), we investigated potential improvements in the SG FRS to predict myocardial infarction risk based on high/low classifications of the Agatston score (surrogate outcome). Logistic regression, receiver operating characteristic and net reclassification index (NRI) analyses were conducted. Results: We demonstrated a significant improvement in the area under curve (AUC) of the SG FRS (AUC=0.641) after recalibration and incorporation of additional variables (fasting glucose and wearable-derived activity levels) (AUC=0.774) (p<0.001). SG FRS++ significantly increases accuracy in risk prediction (NRI=0.219, p=0.00254). Conclusion: We suggest that existing Singapore CVD risk prediction guidelines be updated to improve risk prediction accuracy. Recalibrating existing risk functions and utilising wearable metrics which provide a large pool of objective health data can help improve existing risk prediction tools. Lastly, activity levels and pre-diabetic state are important factors to consider for CHD risk stratification methods, especially in low-risk individuals.

scholarly journals Temporal trends in cardiovascular risk factors and performance of the Framingham Risk Score and the Pooled Cohort Equations

2018 ◽  
Vol 73 (1) ◽  
pp. 19-25 ◽  
Author(s):  
Susanne Rospleszcz ◽  
Barbara Thorand ◽  
Tonia de las Heras Gala ◽  
Christa Meisinger ◽  
Rolf Holle ◽  
...  
Keyword(s):  
Risk Prediction ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Prediction Models ◽  
Temporal Trends ◽  
Discrimination Performance ◽  
Risk Scores ◽  
Western World ◽  
Cvd Risk ◽  
Framingham Risk

BackgroundThe Framingham Risk Score (FRS) and the Pooled Cohort Equations (PCE) are established tools for the prediction of cardiovascular disease (CVD) risk. In the Western world, decreases in incidence rates of CVD were observed over the last 30 years. Thus, we hypothesise that there are also temporal trends in the risk prediction performance of the FRS and PCE from 1990 to 2000.MethodsWe used data from n=7789 men and women aged 40–74 years from three prospective population-based cohort studies enrolled in Southern Germany in 1989/1990, 1994/1995 and 1999/2000. 10-year CVD risk was calculated by recalibrated equations of the FRS or PCE. Calibration was evaluated by percentage of overestimation and Hosmer-Lemeshow tests. Discrimination performance was assessed by receiver operating characteristic (ROC) curves and corresponding area under the curve (AUC).ResultsAcross the three studies, we found significant temporal trends in risk factor distributions and predicted risks by both risk scores (men: 18.0%, 15.4%, 14.9%; women: 8.7%, 11.2%, 10.8%). Furthermore, also the discrimination performance evolved differently for men (AUC PCE: 76.4, 76.1, 72.8) and women (AUC PCE: 75.9, 79.5, 80.5). Both risk scores overestimated actual CVD risk.ConclusionThere are temporal trends in the performance of the FRS and PCE. Although the overall performance remains adequate, sex-specific trends have to be taken into account for further refinement of risk prediction models.

Cardiovascular risk prediction in the general population with use of suPAR, CRP, and Framingham Risk Score

2013 ◽  
Vol 167 (6) ◽  
pp. 2904-2911 ◽  
Author(s):  
Stig Lyngbæk ◽  
Jacob L. Marott ◽  
Thomas Sehestedt ◽  
Tine W. Hansen ◽  
Michael H. Olsen ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
General Population ◽  
Risk Prediction ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Framingham Risk ◽  
Cardiovascular Risk Prediction

scholarly journals Does Adding Adverse Pregnancy Outcomes Improve the Framingham Cardiovascular Risk Score in Women? Data from the Tehran Lipid and Glucose Study

2022 ◽  
Author(s):  
Marzieh Saei Ghare Naz ◽  
Ali Sheidaei ◽  
Ali Aflatounian ◽  
Fereidoun Azizi ◽  
Fahimeh Ramezani Tehrani
Keyword(s):  
Risk Factors ◽  
Risk Score ◽  
Pregnancy Outcomes ◽  
Framingham Risk Score ◽  
Adverse Pregnancy Outcomes ◽  
Proportional Hazard ◽  
Cvd Risk ◽  
C Statistic ◽  
Framingham Risk ◽  
Adverse Pregnancy

Background Limited and conflicting evidence is available regarding the predictive value of adding adverse pregnancy outcomes (APOs) to established cardiovascular disease (CVD) risk factors. Hence, the objective of this study was to determine whether adding APOs to the Framingham risk score improves the prediction of CVD events in women. Methods and Results Out of 5413 women who participated in the Tehran Lipid and Glucose Study, 4013 women met the eligibility criteria included for the present study. The exposure and the outcome variables were collected based on the standard protocol. Cox proportional hazard model was used to evaluate the association of APOs and CVDs. The variant of C‐statistic for survivals and reclassification of subjects into Framingham risk score categories after adding APOs was reported. Out of the 4013 eligible subjects, a total of 1484 (36.98%) women reported 1 APO, while 395 (9.84%) of the cases reported multiple APOs. Univariate proportional hazard Cox models showed the significant relations between CVD events and APOs. The enhanced model had a higher C‐statistic indicating more acceptable discrimination as well as a slight improvement in discrimination (C‐statistic differences: 0.0053). Moreover, we observed a greater risk of experiencing a CVD event in women with a history of multiple APOs compared with cases with only 1 APO (1 APO: hazard ratio [HR] = 1.22; 2 APOs: HR; 1.94; ≥3 APOs: HR = 2.48). Conclusions Beyond the established risk factors, re‐estimated CVDs risk by adding APOs to the Framingham risk score may improve the accurate risk estimation of CVD. Further observational studies are needed to confirm our findings.

scholarly journals 7500 steps per day is associated with lower cardiovascular risk in rural residents with a high prevalence of sedentary lifestyle

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
I Madujibeya ◽  
L Misook ◽  
T Lennie ◽  
G Mudd-Martin ◽  
M Biddle ◽  
...  
Keyword(s):  
Risk Score ◽  
Rural Areas ◽  
Framingham Risk Score ◽  
Step Count ◽  
Daily Step ◽  
Cvd Risk ◽  
Rural Residents ◽  
Physically Active ◽  
Framingham Risk ◽  
Daily Step Count

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Sedentary lifestyle is one of the modifiable risk factors that account for the high prevalence of cardiovascular diseases (CVD) in the rural areas.1,2 Daily step counting, using wearable devices, is increasingly used to monitor physical activity levels in interventions targeting CVD risk reduction in the rural areas.3,4 However, there is a lack of evidence to support a daily step count threshold that may reduce CVD risk among rural residents. The purpose of this study was to examine the relationship between daily step count cut-points and CVD risk. Methods This secondary analysis included 312 adults living in the rural areas in the southern United States. Daily step counts from pedometers were collected for 14 consecutive days. Established cut-points were used to categorize participants into groups based on mean daily step count as sedentary (≤ 5000 steps/day), less active (5000 -7499 steps/per), and physically active (≥7500 steps/day).5-7 CVD risk was measured with the Framingham risk score. Generalized additive models were used to examine differences among the 3 activity groups in Framingham risk score, controlling for educational level, perceived physical health status, depressive, marital status, and years of residence in a rural county. Results Among the participants (75% female, mean age 50.1 (±13.6) years), 40.7% were sedentary, 35.2% were less active, and 24.0% were physically active. The average Framingham risk score was 11.2% (±9.4%). Framingham risk scores were 1.7% lower in the less active compared to the sedentary group, but the effect was not significant (p &lt;  .11), and 2.6% lower in the physically active compared to the sedentary group (p &lt; .04). The model accounted for 22% of the variation in Framingham risk scores. Conclusion These findings indicate that rural residents who averaged 7500 steps or more per day had lower CVD risk, and the difference is clinically significant.

The impact of bariatric surgery on framingham risk score

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A.K.H Ho ◽  
C.J O'Boyle ◽  
H Shabana ◽  
K.J Lee
Keyword(s):  
Blood Pressure ◽  
Bariatric Surgery ◽  
Risk Reduction ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Density Lipoprotein ◽  
T Test ◽  
Cvd Risk ◽  
Framingham Risk ◽  
The Impact

Abstract Introduction Although morbid obesity is strongly associated with cardiovascular disease (CVD) risk, relatively little research has been performed to evaluate the long-term effect of bariatric surgery (BS) on CVD risk reduction. Purpose To evaluate the 2-year effects of laparoscopic gastric bypass (LGBYP) & laparoscopic sleeve gastrectomy (LSG) on blood pressure, lipid profile, diabetic profile and Framingham risk score (FRS). Methods It was a retrospective review of patients undergoing BS between January 2009–2017. Body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), lipid & diabetic profile were recorded preoperatively & 2-year postoperatively. Results Of 416 patients, 77% (320) were females, 88% (365) were non-smokers & mean (sd) age was 48 (11) years. 69% (286) underwent LGBYP. 27% (114) were diabetic, 78% (324) were hyperlipidaemic and 65% (269) were hypertensive. The mean SBP & DBP decreased progressively while mean high-density-lipoprotein (HDL) & total-cholesterol (TC) increased progressively (table 1). LGBYP has a greater reduction in DBP than LSG (p&lt;0.001, t-test). 10-year CVD risk reduced by 37% at 2-year, with a greater effect in LGBYP than LSG (40% vs 28%, p&lt;0.001, t-test). Conclusion The 10-year risk of CVD reduced by 37% 2-years after bariatric surgery, with a greater risk reduction in LGBYP compared to LSG. Funding Acknowledgement Type of funding source: None

scholarly journals Cardiovascular Risk, Obesity, and Sociodemographic Indicators in a Brazilian Population

2021 ◽  
Vol 9 ◽  
Author(s):  
Nayla Cristina do Vale Moreira ◽  
Ibrahimu Mdala ◽  
Akhtar Hussain ◽  
Bishwajit Bhowmik ◽  
Tasnima Siddiquee ◽  
...  
Keyword(s):  
Risk Score ◽  
Central Obesity ◽  
Framingham Risk Score ◽  
Population Based ◽  
Brazilian Population ◽  
Sociodemographic Characteristics ◽  
Cross Sectional Survey ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Framingham Risk

Background and Aims: Cardiovascular diseases (CVDs) are the leading cause of death globally and in Brazil. Evidence suggests that the risk of CVDs differs by race/ethnicity. Scarce information exists about the association between CVD risk, obesity indicators and sociodemographic characteristics in the Brazilian population.Objectives: We aimed to assess the CVD risk following the Framingham risk score in relation to the population's sociodemographic profile. Further, we examined the association between anthropometric markers and risk of CVDs.Methods: A total of 701 subjects aged ≥20 years from North-eastern Brazil were recruited randomly to participate in a population-based, cross-sectional survey. Age-adjusted data for CVD risk, sociodemographic characteristics, and anthropometric indices were assessed, and their relationships examined.Results: High CVD risk (Framingham risk score ≥10%) was observed in 18.9% of the population. Males (31.9 vs. 12.5%) and older subjects (age ≥45 years: 68.9% vs. age &lt;45 years: 4.2%) had significantly higher risk of CVDs, whereas those employed in manual labor showed lower risk (7.6 vs. 21.7%). Central obesity measures like waist-to-hip ratio and waist-to-height ratio were more strongly associated with predicted CVD risk than body mass index.Conclusions: Our population had a high risk of CVDs using the Framingham risk score. Cost-effective strategies for screening, prevention and treatment of CVDs may likely reduce disease burden and health expenditure in Brazil. Central obesity measures were strongly associated with predicted CVD risk and might be useful in the clinical assessment of patients. Follow-up studies are warranted to validate our findings.

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