INTRODUCTION: The Framingham Risk Score (FRS) is a well-validated epidemiologic tool used to assess the risk for a fi rst cardiac event. Because young patients presenting with a fi rst myocardial infarction (MI) tend to have less significant risk profiles compared with older patients, we hypothesized that FRS may underestimate cardiac risk in these patients. MATERIALS AND METHODS: We studied 1267 patients between January 2002 and November 2007 presenting with a fi rst MI. Patients with pre-existing diabetes mellitus and vascular disease were excluded. FRS was calculated for each patient. Patients were divided based on their age: group A (<40 years), group B (40 to 64 years) and group C (> or =65 years). RESULTS: The mean age was 54.7 +/- 11 years, 88.4% of the patients were males. Younger patients were more likely to be assigned with lower scores. Based on FRS, 63.0%, 29.3% and 14.2% of group A, B and C patients were classified as low risk (10-year risk for cardiac events<10%) respectively, P <0.001. The sensitivity of FRS in identifying at least intermediate risk subjects (10-year risk for cardiac events >10%) was 37.0% in group A vs 85.8% in group C (P <0.001). The incidence of newly diagnosed diabetes mellitus was higher in younger patients (12.0% vs 13.2% vs 7.1 % in groups A, B and C respectively, P = 0.027). CONCLUSIONS: FRS inadequately predicts cardiac risk in young patients presenting with a fi rst MI. This could be because a significant proportion of these young patients have undiagnosed diabetes mellitus, a coronary artery disease risk equivalent.
INTRODUCTION: The Framingham Risk Score (FRS) is a well-validated epidemiologic tool used to assess the risk for a fi rst cardiac event. Because young patients presenting with a fi rst myocardial infarction (MI) tend to have less significant risk profiles compared with older patients, we hypothesized that FRS may underestimate cardiac risk in these patients. MATERIALS AND METHODS: We studied 1267 patients between January 2002 and November 2007 presenting with a fi rst MI. Patients with pre-existing diabetes mellitus and vascular disease were excluded. FRS was calculated for each patient. Patients were divided based on their age: group A (<40 years), group B (40 to 64 years) and group C (> or =65 years). RESULTS: The mean age was 54.7 +/- 11 years, 88.4% of the patients were males. Younger patients were more likely to be assigned with lower scores. Based on FRS, 63.0%, 29.3% and 14.2% of group A, B and C patients were classified as low risk (10-year risk for cardiac events<10%) respectively, P <0.001. The sensitivity of FRS in identifying at least intermediate risk subjects (10-year risk for cardiac events >10%) was 37.0% in group A vs 85.8% in group C (P <0.001). The incidence of newly diagnosed diabetes mellitus was higher in younger patients (12.0% vs 13.2% vs 7.1 % in groups A, B and C respectively, P = 0.027). CONCLUSIONS: FRS inadequately predicts cardiac risk in young patients presenting with a fi rst MI. This could be because a significant proportion of these young patients have undiagnosed diabetes mellitus, a coronary artery disease risk equivalent.
Authors: Oliver Riedel; C Ohlmeier; D Enders; A Elsässer; D Vizcaya; A Michel; S Eberhard; N Schlothauer; J Berg; E Garbe Journal: Clin Res Cardiol Date: 2018-02-05 Impact factor: 5.460
Authors: Seamus P Whelton; Khurram Nasir; Michael J Blaha; Heidi Gransar; Thomas S Metkus; Josef Coresh; Daniel S Berman; Roger S Blumenthal Journal: Circ Cardiovasc Qual Outcomes Date: 2012-07-01
Authors: Sinead Brophy; Roxanne Cooksey; Michael B Gravenor; Clive Weston; Steven M Macey; Gareth John; Rhys Williams; Ronan A Lyons Journal: BMC Public Health Date: 2010-06-14 Impact factor: 3.295
Authors: Liang Guo; Xiaofan Guo; Ye Chang; Jun Yang; Limin Zhang; Tan Li; Yingxian Sun Journal: Int J Environ Res Public Health Date: 2016-07-29 Impact factor: 3.390