Effect of serum lipid level change on 10-year coronary heart risk distribution estimated by means of seven different coronary risk scores during one-year treatment

Abstract

This study was done in order to evaluate the effect of serum levels of total cholesterol, triglycerides, low-density lipoprotein-cholesterol and high-density lipoprotein-cholesterol on 10-year coronary heart disease risk distribution change. This study included 110 subjects of both genders (71 female and 39 male), aged 29 to 73, treated at the Outpatient Department of Atherosclerosis Prevention, Centre for Laboratory Medicine, Clinical Centre Vojvodina. The 10-year coronary heart disease risk was estimated on first examination and after one-year treatment by means of Framingham, PROCAM and SCORE coronary risk scores and their modifications (Framingham Adult Treatment Panel III, Framingham Weibul, PROCAM NS and PROCAM Cox Hazards). Age, gender, systolic and diastolic blood pressure, smoking, positive family history and left ventricular hypertrophy are risk factors involved in the estimation of coronary heart disease besides lipid parameters. There were no significant differences in nutritional status, smoking habits, systolic and diastolic pressure, and no development of diabetes mellitus or cardiovascular incidents during one-year follow. However, a significant reduction in cholesterol level (p < 0.001), triglycerides (p < 0.001), low-density lipoprotein cholesterol (p < 0.001) and an increase in high-density lipoprotein cholesterol (p < 0.02) was present although therapeutic target values were not achieved. In addition, a significant increase was observed in the category of low 10-year coronary heart disease risk (Framingham- p < 0.001; Framingham ATP III- p < 0.001; Framingham Weibul- p < 0.001; PROCAM- p < 0.05; PROCAM NS- p < 0.05; PROCAM Cox Hazards- p < 0.001: SCORE- p < 0.001) and a reduction in high-risk category (Framingham- p < 0.001; Framingham ATP III- p < 0.005; Framingham Weibul- p < 0.005; PROCAM- p < 0.001; PROCAM NS-p < 0.001; PROCAM Cox Hazards- p < 0.001; SCORE- p < 0.005) in comparison with the risk at the beginning of the study. Our results show that the correction of lipid level after one-year treatment leads to a significant redistribution of 10-year coronary heart disease risk estimated by means of seven different coronary risk scores. This should stimulate patients and doctors to persist in prevention measures.