framingham risk
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Author(s):  
Marzieh Saei Ghare Naz ◽  
Ali Sheidaei ◽  
Ali Aflatounian ◽  
Fereidoun Azizi ◽  
Fahimeh Ramezani Tehrani

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.


Author(s):  
Inhwan Lee ◽  
Jeonghyeon Kim ◽  
Hyunsik Kang

Background: The added value of non-exercise-based estimation of cardiorespiratory fitness (eCRF) to cardiovascular disease (CVD) risk factors for mortality risk has not been examined in Korean populations. Methods: This population-based prospective cohort study examined the relationship of the 10-year Framingham risk score (FRS) for CVD risk and eCRF with all-cause and CVD mortality in a representative sample of Korean adults aged 30 years and older. Data regarding a total of 38,350 participants (16,505 men/21,845 women) were obtained from the 2007–2015 Korea National Health and Nutrition Examination Survey (KNHANES). All-cause and CVD mortality were the main outcomes. The 10-year FRS point sum and eCRF level were the main exposures. Results: All-cause and CVD mortality was positively correlated with the 10-year FRS point summation and inversely correlated with eCRF level in this study population. The protective of high eCRF against all-cause and CVD mortality was more prominent in the middle and high FRS category than in the low FRS category. Notably, the FRS plus eCRF model has better predictor power for estimating mortality risk compared to the FRS only model. Conclusions: The current findings indicate that eCRF can be used as an alternative to objectively measured CRF for mortality risk prediction.


2021 ◽  
Vol 9 ◽  
Author(s):  
Nayla Cristina do Vale Moreira ◽  
Ibrahimu Mdala ◽  
Akhtar Hussain ◽  
Bishwajit Bhowmik ◽  
Tasnima Siddiquee ◽  
...  

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 <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.


2021 ◽  
Vol 8 ◽  
Author(s):  
Guisen Lin ◽  
Qile Liu ◽  
Yuchen Chen ◽  
Xiaodan Zong ◽  
Yue Xi ◽  
...  

Aim: Patients with ischemic stroke (IS), transient ischemic attack (TIA), and/or peripheral artery disease (PAD) represent a population with an increased risk of coronary artery disease. Prognostic risk assessment to identify those with the highest risk that may benefit from more intensified treatment remains challenging. To explore the feasibility and capability of machine learning (ML) to predict long-term adverse cardiac-related prognosis in patients with IS, TIA, and/or PAD.Methods: We analyzed 636 consecutive patients with a history of IS, TIA, and/or PAD. All patients underwent a coronary CT angiography (CCTA) scan. Thirty-five clinical data and 34 CCTA metrics underwent automated feature selection for ML model boosting. The clinical outcome included all-cause mortality (ACM) and major adverse cardiac events (MACE) (ACM, unstable angina requiring hospitalization, non-fatal myocardial infarction (MI), and revascularization 90 days after the index CCTA).Results: During the follow-up of 3.9 ± 1.6 years, 21 patients had unstable angina requiring hospitalization, eight had a MI, 23 had revascularization and 13 deaths. ML demonstrated a significant higher area-under-curve compared with the modified Duke index (MDI), segment stenosis score (SSS), segment involvement score (SIS), and Framingham risk score (FRS) for the prediction of ACM (ML:0.92 vs. MDI:0.66, SSS:0.68, SIS:0.67, FRS:0.51, all P < 0.001) and MACE (ML:0.84 vs. MDI:0.82, SSS:0.76, SIS:0.73, FRS:0.53, all P < 0.05).Conclusion: Among the patients with IS, TIA, and/or PAD, ML demonstrated a better capability of predicting ACM and MCAE than clinical scores and CCTA metrics.


Author(s):  
Sock Hwee Tan ◽  
Hiromi W.L. Koh ◽  
Jing Yi Chua ◽  
Bo Burla ◽  
Ching Ching Ong ◽  
...  

Objective: While the risk of acute coronary events has been associated with biological variability of circulating cholesterol, the association with variability of other atherogenic lipids remains less understood. We evaluated the longitudinal variability of 284 lipids and investigated their association with asymptomatic coronary atherosclerosis. Approach and Results: Circulating lipids were extracted from fasting blood samples of 83 community-sampled symptom-free participants (age 41–75 years), collected longitudinally over 6 months. Three types of coronary plaque volume (calcified, lipid-rich, and fibrotic) were quantified using computed tomography coronary angiogram. We first deconvoluted between-subject (CV g ) and within-subject (CV w ) lipid variabilities. We then tested whether the mean lipid abundance was different across groups categorized by Framingham risk score and plaques phenotypes (lipid-rich, fibrotic, and calcified). Last, we investigated whether visit-to-visit variability of each lipid was associated with plaque burden. Most lipids (72.5%) exhibited higher CV g than CV w . Among the lipids (N=145) with 1.2-fold higher CV g than CV w , 26 species including glycerides and ceramides were significantly associated with Framingham risk score and the 3 plaque phenotypes (false discovery rate <0.05). In an exploratory analysis of person-specific visit-to-visit variability without multiple-comparisons testing, high variability of 3 lysophospholipids (lysophosphatidylcholines 16:0, 18:0, and O-18:1) were associated with lipid-rich and fibrotic (noncalcified) plaque volume while high variability of diacylglycerol 18:1_20:0, triacylglycerols 52:2, 52:3, and 52:4, ceramide d18:0/20:0, dihexosylceramide d18:1/16:0, and sphingomyelin 36:3 were associated with calcified plaque volume. Conclusions: High person-specific longitudinal variation of specific nonsterol lipids are associated with the burden of subclinical coronary atherosclerosis. Larger studies are needed to confirm these exploratory findings.


2021 ◽  
Author(s):  
Olubunmi Abiola Olubiyi ◽  
Bosede Folashade Rotimi ◽  
Munirat Ayoola Afolayan ◽  
Bilqis Wuraola Alatishe-Muhammed ◽  
Olufemi Mubo Olubiyi ◽  
...  

Abstract Background: Estimation of total cardiovascular disease (CVD) risk with the use of risk prediction charts such as the Framingham risk score and Atherogenic index of plasma score is a huge improvement on the practice of identifying and treating each of the risk factors such as high blood pressure and elevated blood cholesterol. The estimation of the total risk highlights that CVD risk factors occur together and thereby predicts who should be treated. There is scarcity of data on the risk scoring of adults in Nigeria including health workers. Therefore, this study was done to estimate the cardiovascular risks of health workers in public health services in north-central NigeriaMethods: A cross-sectional survey was performed using validated Framingham risk score calculator and calculation of risk based on the lipid profile of 301 randomly selected health workers in North-central Nigeria. Descriptive analysis was done using frequency counts and percentages while inferential statistics were done using chi square and correlation analyses using statistical Package for Social Sciences (SPSS) version 21.0. The confidence level was 95% and the level of significance was set at 0.05.Results: The 10-year risk of developing CVD was generally low in the health workers. Using Framingham risk score, 98.3% of health workers have low risk, 1.0% have moderate risk and 0.7% have high risk. Among the cadres of health workers, 1.5% of the nurses have moderate risk while 2.5% of the doctors and 3.3% of the CHEWs have high risk of developing CVD in 10 years. Using Atherogenic index of plasma scoring, only 2% of the health workers have high risk, 4.7% have intermediate risk while 93.4% have low risk. Across the cadres, 6.3% of the nurses and 3.3% of the CHEWs have intermediate risk while 2.4% of the nurses and 3.3% of the CHEWs have high risk. These findings were however not statistically significant.Conclusions: the 10-year risk of developing cardiovascular disease was low in the health workers in this study using both Framingham’s risk score and atherogenic index of plasma scores


2021 ◽  
Vol 8 (3) ◽  
pp. 186-189
Author(s):  
Gunavathi G ◽  
Muruganantham B ◽  
Harissh Ganesan ◽  
Manasha Devi

Cardiovascular disease is one of the leading causes of mortality in haemodialysis patients. Several studies have demonstrated the relation of zinc and magnesium in cardiovascular disease. In present study we aimed to measure serum zinc and magnesium levels and correlate with the Framingham score to calculate the cardiovascular risk.Present study was prospective, cross sectional type, conducted in chronic kidney disease patients undergoing haemodialysis.Serum magnesium, zinc, cholesterol, urea, creatinine, HDL cholesterol, systolic BP are measured and Framingham score was calculated. And zinc and magnesium values were correlated with Framingham score. The study is conducted in 100 CKD patients undergoing hemodialysis. Out of 100 CKD patients undergoing hemodialysis, 59% had high risk,28% had intermediate risk, and 13% had low risk of developing cardiovascular disease according to their Framingham risk score. In these patients, zinc and magnesium levels were found and correlated with Framingham risk score. Out of 100 patients undergoing hemodialysis, 37 patients were hypomagnesemic, 43 patients were normomagnesemic, 20 patients were hypermagnesemic. In this, a positive correlation was found between development of hypomagnesemia and duration of hemodialysis. Magnesium level was correlated with Framingham risk score. In this hypomagnesemic patients, 67% patients have low risk, 8% have intermediate risk, 24% patients have high risk of developing heart disease. Out of 100 patients, 86 patients have normal zinc level, 14 patients have increased zinc level. Zinc levels was not altered during dialysis. These patients already have risk of developing heart disease independent of zinc level.In our study, magnesium level of haemodialysis patients was reduced and it is associated with duration of haemodialysis. Zinc levels were not altered in the patients.


Author(s):  
CYI Yeo ◽  
JC Jr Allen ◽  
W Huang ◽  
WY Tan ◽  
SC Kong ◽  
...  

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.


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