Comparison of the Framingham risk and score models in predicting the presence and severity of coronary artery disease considering SYNTAX score

Abstract

Objective:Although various risk stratification models are available and currently being used, the performance of these models in different populations is still controversial. We aimed to investigate the relation between the Framingham and SCORE models and the presence and severity of coronary artery disease, which is detected using the SYNTAX score.Methods:The observational cross-sectional study population consisted of 227 patients with a mean age of 63.3±9.2 years. The patients were classified into low- and high-risk groups in the Framingham and SCORE models separately. Following coronary angiography, the patients were classified into SYNTAX=0 (SYNTAX score 0), low SYNTAX (SYNTAX score 1–22), and high SYNTAX (SYNTAX score>22) groups. The relation between the risk models and SYNTAX score was evaluated by student t test, Mann–Whitney U test or Kruskal–Wallis test and Receiver operating characteristic analysis were used to detect the discrimination ability in the prediction of SYNTAX score>0 and a high SYNTAX score.Results:Both the Framingham and SCORE models were found to be effective in predicting the presence of coronary artery disease, and neither of the two models had superiority over each other [AUC=0.819 (0.767, 0.871) vs. 0.811 (0.757, 0.861), p=0.881]. Furthermore, both models were also effective in predicting the extent and severity of coronary artery disease [AUC=0.724 (0.656, 0.798) vs. 0.730 (0.662, 0.802), p=0.224]. When the subgroups were analyzed, the SCORE model was found to be better in predicting coronary artery disease extent and severity in subgroups of men and diabetics {[AUC=0.737 (0.668, 0.844) vs. 0.665 (0.560, 0.790), p=0.019], [AUC=0.733 (0.684, 0.798) vs. 0.680 (0.654, 0.750) p=0.029], respectively).Conclusion:In addition to their role in predicting cardiovascular events, the use of the Framingham and SCORE models may also have utility in predicting the extent and severity of coronary artery disease. The SCORE risk model has a slightly better performance than the Framingham risk model.

Mean Platelet Volume as a Predictor of Atherosclerotic Severity in Non ST Elevation Acute Myocardial Infarction

“…1 In research by Gunaydin et al (2016), it was found that HDL and family history had a significant implication for the incidence of high Syntax scores. 5 This is consistent with our study with significant association in family history and in HDL level for higher Syntax score ( Table 3).…”

“…This is in line with the research conducted by Gunaydin et al (2016). 5 In the univariate analysis, it was found risk factors for family history and HDL levels showed significant differences. Previous studies revealed that low HDL was caused by increased proliferation of megakaryocyte progenitors and increased production of immature platelets in the bone marrow, thus the relationship between high MPV and low HDL could reflect the presence of an atherogenic and significant CHD.…”

“…1 Other study showed that HDL and family history had a significant p value for the incidence of high SYNTAX. 5 Hindieh et al (2014) showed that a family history of coronary heart disease is associated with the severity of coronary anatomics lesions and needs to be given earlier and more aggressive attention in the management of CAD. 11 Study conducted by Murat et al (2013) show for the first time a positive relationship between MPV and the severity of CAD with Gensini scores and SYNTAX scores.…”

Lipid Profiles and Framingham Risk Score in Patients with Coronary Artery Bypass Graft Surgery undergoing Cardiac Rehabilitation Program

“…The information included in the Framingham risk comprised the followings: age, gender, smoking status, systolic blood pressure, total and HDL cholesterol levels, the positive diagnosis of diabetes mellitus (DM) or the absence of diabetes, and the existence of hypertension (HT) under treatment or without medication. The total score revealed by the Framingham risk score allowed an estimation of a 10-year risk of developing coronary heart disease [1,2].…”

Consensus clinical recommendations for the management of plasma lipid disorders in the Middle East

“…A Turkish study of patients undergoing coronary angiography for the assessment of coronary artery disease (CAD) due to chest pain and ischaemia (n = 227), found that a FRF score calculated before angiography was in general predictive of the presence, extent and severity of CAD. The score was more predictive in patients with hypertension, obesity or a family history of the disorder and less predictive in male patients and in those with diabetes [53]. A large Iranian study (n = 46,674) reported the performance of the office-based version of the FRF in predicting fatal CVD events to be comparable with that of previously tested models [51].…”