Framingham Risk Score Values Research Articles

The Relationship of Trace Element Levels with Obesity and Cardiovascular Health

Objective: One of the most important factors affecting cardiovascular health is obesity. Trace elements, which play a role in every stage of metabolism, are also related to our cardiovascular health. The aim of this study was to determine serum trace element levels in individuals and to examine the relationship between trace elements and cardiovascular risk. Methods: This cross-sectional study was conducted with individuals who applied to the outpatient clinic between 01.03.2022-31.04.2022. Sociodemographic characteristics, BMI, and Framingham risk score values were recorded. Serum iron, zinc, copper and selenium levels were analyzed in the laboratory. Results: A total of 180 individuals were included in the study. Of the individuals, 33.3% were overweight and 32.8% were obese. The mean Framingham Risk Score (FRS) was 9.31±7.99 (1-37). FRS values of normal weight individuals (7.84±3.05) were lower than the mean FRS values of overweight (8.80±3.39) and obese (13.39 ± 6.24) groups (p

Relationship Between the Risk of Coronary Heart Disease and Nutritional Status of Adult

Cardiovascular diseases (CVD) have the highest prevalence among non-communicable diseases so prevention from CVD is very important. The aim of this study was to determine the risk of cardiovascular events in adults over the next 10 years with the Framingham Risk Score (FRS) and to evaluate the relationship between this risk and the nutritional patterns of individuals. This study was conducted with a total of 238 individuals (78 males, 160 females) aged between 30-64 years. Energy, micro and macronutrients intake levels of the participants according to FRS and gender were determined by taking a daily food consumption record with a 24-hour retrospective reminder method. Participants’ ten-year coronary disease risk was assessed with FRS which was classified as low risk (<10%), moderate risk (10-20%), and high risk (>20%). While 44.9% of the men had moderate/high coronary disease risk, all of women had low risk. Energy, many macronutrients and micronutrients intake levels of men with low risk of coronary heart diseases (CHD) were higher than women. FRS values of all individuals participating in the research were related to energy, carbohydrate (g, %), protein (g), total fat (%), mono-unsaturated fatty acid/MUFA (g), poly-unsaturated fatty acid/PUFA (%), riboflavin, sodium, and zinc. Of these parameters, total fat and PUFA were negatively correlated, while the others were positively correlated. The parameter that most affected the FRS value was carbohydrate (g). These results clearly demonstrate the relationship between nutrition and CVD risk. Therefore, identifying individuals with medium/high FRS and taking nutritional initiatives are important in reducing the CVD prevalence and health costs.

Atherogenic Index of Plasma in Women with Rheumatoid Arthritis and Systemic Lupus Erythematosus: A 10-Year Potential Predictor of Cardiovascular Disease.

Women with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) are at high risk of cardiovascular diseases (CVD). The atherogenic index of plasma (AIP) is a new marker for the assessment of CVD. This study aimed to determine the predictive value of AIP with long-term CVD risk among women with RA and SLE. This is a cross-sectional study of 99 RA and 59 SLE women. Demographic, clinical, and biochemical data were obtained, and disease activities were calculated. For each patient, the longterm risk of CVD was calculated using the Framingham risk score (FRS); AIP was derived according to the logarithmic (triglycerides/high-density lipoproteins cholesterol). The mean age of the RA and SLE patients was 47.97 ± 8.78 and 36.75 ± 9.09 years, respectively. The median (interquartile range) of AIP values in RA and SLE patients were 0.34 (-0.15, 1.02) and 0.33 (-0.53, 0.96), respectively, while FRS values of RA patients and SLE patients were 6.38 ± 5.58 and 4.86 ± 4.5, respectively (p >0.05). There was a moderate correlation between AIP and FRS in RA and SLE patients (r=0.42, p=0.002 and r=0.33, p=0.007, respectively). According to the multivariate regression analyses, we found that AIP value is an independent factor for FRS in RA (β: 4.13, 95% confidence interval; 1.71, 6.18; p=0.008) and in SLE patients (β: 6.19, 95% confidence interval; 2.58, 9.81; p<0.001). We reported that AIP can be used as an independent indicator for long-term CVD risk in RA and SLE patients.

Impact of Metabolic Syndrome Components in High-Risk Cardiovascular Disease Development in Older Adults.

ObjectiveAnalyze the influence between the components of metabolic syndrome and the independent risk for cardiovascular disease (CVD) in the elderly.MethodsA descriptive cross-sectional study was carried out with 205 older adults from a primary healthcare unit of the Federal District, Brazil. The cardiovascular risk was determined by the Framingham Risk Score (FRS). The National Cholesterol Evaluation Program for Adult Treatment Panel III 2001 (NCEP-ATP III) criteria were considered to analyze metabolic syndrome (MS) diagnoses.ResultsThere was a strong association between MS and high cardiovascular risk (OR = 8.86). The univariate analysis main findings revealed that male gender, diabetes, smoking habit, systolic blood pressure, HDL level, high blood glucose, glycated hemoglobin, and LDL level were associated with high cardiovascular risk. FRS increases significantly with the presence of four or more MS components (by 30%, if 4 components are present, and by 40%, if 5 components) when compared with the presence of three or fewer components (P <0.001). A logistic regression analysis of high-risk predictors was described to reduce the effects of confounding and bias factors.ConclusionThe identification of MS associated with high FRS values represents a cascading of adverse effects on the population’s aging process.

弗明汉危险评分在无症状老年人颈动脉易损斑块筛查中的价值研究 The Value of Framingham Risk Score for Screening Carotid Vulnerable Atherosclerotic Plaques in the Asymptomatic Elderly

弗明汉危险评分在无症状老年人颈动脉易损斑块筛查中的价值研究 The Value of Framingham Risk Score for Screening Carotid Vulnerable Atherosclerotic Plaques in the Asymptomatic Elderly

Impact of arsenic exposure on clinical biomarkers indicative of cardiovascular disease risk in Mexican women

An appropriate and precise identification of high-risk individuals to develop cardiovascular diseases (CVD) is of high importance to reduce these kinds of diseases, a major health concern worldwide. Therefore, the aim of this research was to evaluate prognostic CVD biomarkers in Mexican women exposed to inorganic arsenic via drinking water. Then, a cross-sectional study including 190 women was achieved. Urinary arsenic (UAs) levels were analyzed as exposure biomarker to that metalloid. While, plasma asymmetric dimethylarginine (ADMA), adipocyte fatty acid-binding protein (FABP4), adiponectin, and chemerin levels, hypertriglyceridemic waist (HW) phenotype, atherogenic index of plasma (AIP), and Framingham risk score (FRS) were assessed as prognostic CVD biomarkers. Mean UAs level detected in the evaluated urinary samples was 45.0 ± 40.0 μg/g creatinine. In addition, mean plasma ADMA, FABP4, chemerin and adiponectin levels were 0.68 µmol/L, 20.3 ng/mL, 12.5 μg/mL, and 255 ng/mL, correspondingly. Approximately, 54% of women participants displayed an HW phenotype. Regarding AIP and FRS values, 0.12 ± 0.15 and 7.50 ± 8.00 were found, respectively. Besides, strong and significant associations (p < 0.05) between UAs and AIP, ADMA, and FABP4 were distinguished. Also, after a multivariate analysis, the association between those variables persisted after adjustment for traditional risk factors of CVD. In conclusion, according to the results found in this research, the most sensible CVD biomarkers distinguished in this study were AIP, ADMA, and FABP4. Nevertheless, more studies are necessary to confirm the results found in this investigation.

Endogenous testosterone does not improve prediction of incident cardiovascular disease in a community-based cohort of adult men: results from the Tehran Lipid and Glucose Study

Introduction: To explore the predictive value of testosterone added to the Framingham Risk Score (FRS) for cardiovascular disease (CVD).Methods: Among 816 men, 30–70 years/old, without prevalent CVD, from a community-based cohort (Tehran Lipid and Glucose Study), we assessed the predictive value of testosterone with incident CVD, using three multivariate Cox proportional-hazards models. Model I: FRS variables; model II: Model I plus total testosterone; model III: Model II plus Systolic blood pressure (SBP) * total testosterone (the best fit interaction-term between testosterone and FRS variables). Discriminations and goodness-of-fit were assessed by the C-statistic and the approach of Grønnesby, respectively. p Value <.05 was significant.Results: During 12 years of follow-up, 121 CVD events occurred. In all models, age, treated SBP, smoking, and diabetes were associated with increased CVD (p values <.05). Neither testosterone (models II and III), nor SBP * testosterone (model III) were associated with CVD (p values >.05). The C-statistics for models I, II, and III were 0.819, 0.820, and 0.821, respectively, indicating no significant improvement in the discrimination power. The models’ goodness-of-fit did not improve compared with the FRS.Conclusion: Testosterone could not add to the predictive value of FRS for CVD in men, either directly, or through interactions with FRS variables.

Single-Center Retrospective Study of Risk Factors and Predictive Value of Framingham Risk Score of Patients with ST Elevation Myocardial Infarction.

The objective of this study was to identify risk factors and clinical profile of the patients presenting with ST elevation myocardial infarction (STEMI). We further evaluated the utility of the Framingham Risk Score (FRS) in the accurate identification of these patients if used before their coronary event. We evaluated the demographic, clinical, and angiographic characteristics of patients admitted with STEMI. We also calculated cardiovascular event risk using the FRS in a subset of patients without prior known coronary artery disease and diabetes mellitus. A total of 44 patients, predominantly men (75%) and white (80%), with a mean age of 56 ± 10 years, were included in our analysis. Cigarette smoking was the predominant risk factor (83%) followed by hypertension (77%) and dyslipidemia (68%). The calculated FRS in a subset of patients without prior coronary artery disease or diabetes mellitus was 14.1% ± 5.8%. Based on the FRS, 8 (36%) patients had a 10-year risk >20% and 14 (63%) patients had a 10-year risk between 10% and 20%. In a series of consecutive patients with STEMI, we observed that high FRS was inadequate in correct identification and risk stratification of the majority of patients who had STEMI. Our study underlines the importance of being familiar with multiple risk scores and choosing the most applicable risk score based on the patient's individual characteristics. In addition, it is important to take into consideration the nontraditional risk factors or measurement of coronary artery calcium as a part of the risk assessment algorithm.

Cardiovascular Risk Assessment in a Cohort of Newly Diagnosed Patients with Obstructive Sleep Apnea Syndrome.

Objectives Obstructive sleep apnea syndrome (OSAS) is associated with increased cardiovascular morbidity and mortality. The aim of this study was to assess whether the 10-year risk for cardiovascular disease in newly diagnosed patients with OSAS is increased. Materials and Methods Recently diagnosed, with polysomnography, consecutive OSAS patients were included. The Systematic Coronary Risk Evaluation (SCORE) and the Framingham Risk Score (FRS) were used to estimate the 10-year risk for cardiovascular disease. Results Totally, 393 individuals (73.3% males), scheduled to undergo a polysomnographic study with symptoms indicative of OSAS, were enrolled. According to apnea-hypopnea index (AHI), subjects were divided in four groups: mild OSAS (AHI 5–14.9/h) was diagnosed in 91 patients (23.2%), moderate OSAS (AHI 15–29.9/h) in 58 patients (14.8%), severe OSAS (AHI > 30/h) in 167 patients (42.5%), while 77 individuals (19.6%) had an AHI < 5/h and served as controls. Increased severity of OSAS was associated with increased SCORE (p < 0.001) and FRS values (p < 0.001). More specifically, a significant correlation was observed both between AHI and SCORE (r=0.251, p < 0.001) and AHI and FRS values (r=0.291, p < 0.001). Furthermore, a negative correlation was observed between FRS values and sleep efficiency (r=−0.224, p=0.006). Conclusions The 10-year risk for cardiovascular morbidity and mortality seems to increase with severity of OSAS. Physicians should bear this finding in mind, in order to seek for and consecutively eliminate risk factors for cardiovascular disease and to prevent future cardiovascular events in OSAS patients.

Correlation study of Framingham risk score and vascular dementia: An observational study.

Vascular dementia (VaD) is one of the most common forms of dementia, and second only to Alzheimer's disease. The purpose of this study was to evaluate the potential diagnostic value of Framingham risk score (FRS) in VaD by investigating the relationship among cardiovascular risks, FRS, and VaD.Data were collected from patients (n = 130) at Tongji Hospital in Wuhan, China. They were divided into 2 groups, including the control group (n = 70) and the VaD group (n = 60). Statistical methods including t-test, logistic regression model, multiple linear regression model, and receiver-operating characteristic (ROC) curve were adopted for the assessment.A significant difference (all P < .05) was observed in systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure, total cholesterol (TC), homosysteine (HCY), glycosylated hemoglobin A1c (HbA1c), FRS, and cerebral white matter lesions (WMLs) between the 2 groups, even after adjusting for age (both P < .05). Age [odds ratio (OR) = 1.20; P = .002], FRS (OR = 1.55; P = .006), and WMLs (OR = 10.17; P = .011) were independent prognostic factors for VaD. The area under the ROC curve (AUC) of FRS for VaD diagnosis prediction was 0.830 (95% confidence interval, 95% CI: 0.730∼ 0.929). There was a significant difference in the AUC between WMLs and WMLs combined with FRS (0.788 (95% CI: 0.667 ∼ 0.880) versus 0.863 (95% CI: 0.754 ∼ 0.936, P = .049). Age, HbA1c, and FRS were negatively correlated with the mini-mental state examination (MMSE) scores (all P < .05) in the VaD group. Moreover, multiple stepwise linear regression analysis showed that the age and FRS were independent predictors of MMSE scores.FRS has a moderate predictive value for the VaD diagnosis, and also increases the risk of cognitive decline.

Framingham risk score for estimation of 10-years of cardiovascular diseases risk in patients with metabolic syndrome

BackgroundThere are a few studies evaluating the predictive value of Framingham risk score (FRS) for cardiovascular disease (CVD) risk assessment in patients with metabolic syndrome in Iran. Because of the emerging high prevalence of CVD among Iranian population, it is important to predict its risk among populations with potential predictive tools. Therefore, the aim of the current study is to evaluate the FRS and its determinants in patients with metabolic syndrome.MethodsIn the current cross-sectional study, 160 patients with metabolic syndrome diagnosed according to the National Cholesterol Education Adult Treatment Panel (ATP) III criteria were enrolled. The FRS was calculated using a computer program by a previously suggested algorithm.ResultsTotally, 77.5, 16.3, and 6.3% of patients with metabolic syndrome were at low, intermediate, and high risk of CVD according to FRS categorization. The highest prevalence of all of metabolic syndrome components were in low CVD risk according to the FRS grouping (P < 0.05), while the lowest prevalence of these components was in high CVD risk group (P < 0.05). According to multiple logistic regression analysis, high systolic blood pressure (SBP) and fasting serum glucose (FSG) were potent determinants of intermediate and high risk CVD risk of FRS scoring compared with low risk group (P < 0.05).ConclusionIn the current study, significant associations between components of metabolic syndrome and different FRS categorization among patients with metabolic syndrome were identified. High SBP and FSG were associated with meaningfully increased risk of CVD compared with other parameters.Trial registrationsThe study is not a trial; the registration number is not applicable.

Erratum. Cardiometabolic Risk in a Rural Ugandan Population. Diabetes Care 2013;36;e143.

In the article cited above, a minor error was made in the calculation of the Framingham Risk Score (FRS). The sentences “The mean value of FRS was 3.30 (SD 6.5), with 3.5% …

Abstract 17709: Framingham Risk Score and Coronary Plaque Characteristics as Assessed by Three-Vessel Optical Coherence Tomography Imaging

Introduction: Clinical prediction models, such as the Framingham Risk Score (FRS), are useful to identify patients at high risk for future events. However, their association with coronary plaque features is largely unknown. Aim: This study aimed at evaluating the relationship between FRS and coronary plaque features by optical coherence tomography (OCT). Methods: FRS was assessed in 176 patients with coronary artery disease [72 with acute coronary syndrome (ACS), and 104 with stable angina] who underwent 3-vessel OCT imaging. Based on the FRS values, patients were divided into 3 groups: lower FRS (FRS&lt;5%, n=26), intermediate FRS (5%≤FRS&lt;10%, n=105), and higher FRS (FRS≥10%, n=45). Nonculprit coronary plaque features were compared among the 3 groups. Results: A total of 448 nonculprit plaques were identified (lower FRS, n=61; intermediate FRS, n=267; higher FRS, n=120). Compared to the patients with lower and intermediated FRS, those with higher FRS were older (p&lt;0.001), and more likely to have male gender (p&lt;0.001), diabetes (p=0.023), lower HDL-cholesterol (p&lt;0.001) and higher creatinine levels (p=0.023). Compared to the patients with lower FRS, those with higher FRS had greater lipid index (mean lipid arc x lipid length), and tended to have higher prevalence of thin-cap fibroatheroma (TCFA). Patients with higher FRS showed greater prevalence of calcifications compared to those with lower and intermediate FRS. Prevalence of cholesterol crystals was progressively higher across the 3 groups. At multivariate analysis, presentation with ACS (OR, 2.37; 95% CI, 1.27–4.39; p=0.006), and FRS (OR, 1.57 per 5% risk increase; 95% CI, 1.01–2.42, p=0.043) were independent predictors of TCFA. Conclusions: Nonculprit plaques of patients with higher FRS showed greater lipid content, and higher prevalence of calcifications and cholesterol crystals compared to those of patients with lower and intermediate FRS. ACS presentation and FRS were independent predictors of TCFA.

Weak prediction power of the Framingham Risk Score for coronary artery disease in nonagenarians.

BackgroundCoronary artery disease (CAD) is caused by an acute myocardial infarction and is still feared as a life-threatening heart disease worldwide. In order to identify patients at high risk for CAD, previous studies have proposed various risk assessment scores for the prevention of CAD. The most commonly used risk assessment score for CAD worldwide is the Framingham Risk Score (FRS). The FRS is used for middle-aged people; hence, its appropriateness has not been demonstrated to predict the likelihood of CAD occurrence in very elderly people. This article examines the possible predictive value of FRS for CAD in very elderly people over 90 years of age.MethodsData on all patients over 90 years of age who received a cardiac catheter were collected from hospital charts from the Department of Internal Medicine, Saarland University Medical Center, and HELIOS Hospital Wuppertal, Witten/Herdecke University Medical Center, Germany, within a study period from 2004 to 2013. The FRSs and cardiovascular risk profiles of patients over 90 years of age with and without CAD after cardiac catheterization were compared.ResultsOne hundred and seventy-five (91.15%, mean age 91.51±1.80 years, 74 females [42.29%]; 95% confidence interval [CI], 0.87–0.95) of a total 192 of the very elderly patients were found to have CAD. Based on the results of our study, the FRS seems to provide weak predictive ability for CAD in very elderly people (P = 0.3792).ConclusionWe found weak prediction power of FRS for CAD in nonagenarians.

Experience of a single-center in coronary computed tomography angiography

Cardiologia CROATICA Purpose: Coronary computed tomography angiography with calcium scoring measured with Agatston score index provides a diagnosis of coronary atherosclerosis in the patients with subclinical coronary plaque. To evaluate the diagnostic accuracy of Agatston score in comparison with the conventionally used Framingham risk score (FRS) and blood biomarkers in predicting existence of coronary artery disease (CAD) and significant coronary stenosis >50%. Patients and Methods: This retrospective single-center study is evaluating the role of Agatstone score in the prognosis of CAD in patients with previously unknown CAD. 2,597 patients underwent coronary multidetector computed tomography (MDCT) and obtained Agatston score in our Center from June 2012 to April 2014. Scanning was done with dualsource MDCT equipped with two 128-detector row units using the ECG-gating protocol. The mean amount of radiation that was obtained was 6.8 ± 4.5 mSv. The exclusion criteria included Agatston score above 800, atrial fibrillation, pre-existing kidney failure (eGFR 50% or less than 50%. The frequency of demographic and clinical characteristics, blood biomarkers and risk factors were tested between the groups by using chi-squared test and Student T-test as appropriate. To test for factors associated with predicting coronary artery stenosis, likelihood ratio, and receiver operating characteristics analyses were used. Relative risk was calculated in the context of developing coronary artery stenosis greater than 50% in the participants with Agatston score above 100. Results: Out of 2,597 patients participating, 361 patients (mean age 63 ± 8; 227 (63%) of females) with complete data were included in this study. Significant coronary artery stenosis was recorded in 84 (23%) of patients. Mean FRS values were 20 ± 13. Agatstone score (Se 85%, Sp 95%, NPV 95%, PPV 85%, AUC 0.99, 95% CI 0.968 to 1.000, p<0.0001). Conclusion: Among all considered demographic and clinical characteristics, Agatstone score was the most accurate predictor for developing of CAD and significant coronary stenosis.

Comparison of Agatston CT coronary artery calcium score, Framingham score and blood biomarkers as predictors of coronary artery stenosis

Purpose: Coronary CT angiography (CCTA) with calcium scoring measured with Agatston score index provides a diagnosis of coronary atherosclerosis in patients with subclinical coronary plaque. We compared diagnostic accuracy of Agatston score, Framingham Risk score and multiple blood biomarkers in predicting coronary artery disease (CAD) that caused stenosis >50%. Methods: This retrospective single-center study is evaluating the role of Agatstone score in prognostication of coronary artery stenosis in patients who presented with atypical chest pain and non conclusive stress test result. The study included 368 patients with unknown coronary heart disease (mean age 62.2±7.7; 62% of females) who underwent CCTA and obtained Agatston score, in our Center from June 2012 till June 2013. Scanning was done with dual-source MDCT (Somatom Definition FLASH; Siemens Medical Solution, Munich, Germany) equipped with two 128-detector row units using the prospective or retrospective ECG-gating protocol and the mean received amount radiation was 6.85±9.74mSv. Exclusion criteria included pre-existing kidney failure (eGFR <60 mol/min/1.73m 2 ), atrial fibrillation, as well as incomplete data, Agatston score above 800. All patients with heart rate higher than 80/min received beta blocker. The mean heart rate during scanning was 60±9.3/min, and patients body mass index (BMI) 28±3.9. Patients with known cardiovascular risk factors, including hypertension (80%), diabetes mellitus (29%), dyslipidemia (71%) or smoking (25%), and Framingham risk score values (mean 20±11.9) were considered. Blood biomarkers included glucose, C-reactive protein (CRP), total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides and uric acid. Participants were divided in two groups, based on coronary artery stenosis greater than 50% (83; 23% of participants), and the other with stenosis smaller than 50% (285; 77% of participants). Frequency of demographic and clinical charasterics, blood biomarkers and risk factors were tested between the groups by using Chi square test and Student T test as appropriate. Relative Risk was calculated in context of developing coronary artery stenosis greater than 50% in participants with Agatston score above 100. Results: The most acccurate predictor of coronary artery stenosis greater then 50% was Agatstone Score (AUC 0.89, p<0.0001). Agatstone Score higher than 100, had relative risk for developing of coronary stenosis over 50% 15 times higher than values under 100. CRP (AUC 0.76), glucose (AUC