J Korean Med Sci.  2014 Oct;29(10):1391-1397. 10.3346/jkms.2014.29.10.1391.

Impact of Framingham Risk Score, Flow-Mediated Dilation, Pulse Wave Velocity, and Biomarkers for Cardiovascular Events in Stable Angina

• Park KH
• Han SJ
• Kim HS
• Kim MK
• Jo SH
• Kim SA
• Park WJ

• KMID: 2129630
• DOI: http://doi.org/10.3346/jkms.2014.29.10.1391

Abstract

Although the age-adjusted Framingham risk score (AFRS), flow-mediated dilation (FMD), brachial-ankle pulse wave velocity (baPWV), high-sensitivity C-reactive protein (hsCRP), fibrinogen, homocysteine, and free fatty acid (FFA) can predict future cardiovascular events (CVEs), a comparison of these risk assessments for patients with stable angina has not been reported. We enrolled 203 patients with stable angina who had been scheduled for coronary angiography (CAG). After CAG, 134 patients showed significant coronary artery disease. During 4.2 yr follow-up, 36 patients (18%) showed CVEs, including myocardial infarction, de-novo coronary artery revascularization, in-stent restenosis, stroke, and cardiovascular death. ROC analysis showed that AFRS, FMD, baPWV, and hsCRP could predict CVEs (with AUC values of 0.752, 0.707, 0.659, and 0.702, respectively, all P<0.001 except baPWV P=0.003). A Cox proportional hazard analysis showed that AFRS and FMD were independent predictors of CVEs (HR, 2.945; 95% CI, 1.572-5.522; P=0.001 and HR, 0.914; 95% CI, 0.826-0.989; P=0.008, respectively). However, there was no difference in predictive power between combining AFRS plus FMD and AFRS alone (AUC 0.752 vs. 0.763; z=1.358, P=0.175). In patients with stable angina, AFRS and FMD are independent predictors of CVEs. However, there is no additive value of FMD on the AFRS in predicting CVEs.

Keyword

Framingham Risk Score; Flow-Mediated Dilation; Cardiovascular Event

MeSH Terms

Adult
Aged
Angina, Stable/*physiopathology
Biological Markers/analysis/blood
Blood Flow Velocity
Coronary Artery Disease/*diagnosis
Endothelium, Vascular
Female
Heart/*physiopathology
Humans
Male
Middle Aged
Myocardial Infarction/physiopathology
Predictive Value of Tests
Proportional Hazards Models
Pulsatile Flow
Pulse Wave Analysis/*methods
ROC Curve
Risk Assessment
Risk Factors
Biological Markers

Figure

• 

  Fig. 1 Receiver operating characteristic curves of the AFRS and the AFRS plus FMD for the prediction of cardiovascular events. AFRS, age-adjusted Framingham risk score; FMD, flow-mediated dilation.

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