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Similaire à Incremental predictive value of vascular assessments combined with the Framingham Risk Score for prediction of coronary events in subjects of low intermediate risk
Similaire à Incremental predictive value of vascular assessments combined with the Framingham Risk Score for prediction of coronary events in subjects of low intermediate risk (20)
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Incremental predictive value of vascular assessments combined with the Framingham Risk Score for prediction of coronary events in subjects of low intermediate risk
- 1. Incremental Predictive Value of Vascular Assessments Combined with the Framingham Risk Score for Prediction of Coronary Events in Subjects of Low Intermediate Risk Kui-Kai Lau, 1 Yap-Hang Chan, 1 Kai-Hang Yiu, MBBS, 1 Sidney Tam, MD, 2 Sheung-Wai Li, MBBS, 3 Chu-Pak Lau, MD, 1 Hung-Fat Tse, MD,PhD. 1 1 Cardiology Division, The University of Hong Kong, 2 Department of Clinical Biochemistry Unit, Queen Mary Hospital, and 3 Department of Medicine, Tung Wah Hospital, Hong Kong, China.
- 9. Clinical Characteristics of Study Population 1.0 35 (100) 70 (100) Males, n (%) <0.001 1 (3) 55 (79) Lipid lowering therapy, n (%) <0.001 10 (29) 62 (89) Anti-hypertensives, n (%) 0.10 1 (3) 9 (13) Family history of cardiovascular disease, n (%) 0.27 15 (43) 38 (54) Smoking, n (%) 1.0 0 (0) 0 (0) Diabetes, n (%) 0.002 19 (54) 58 (83) Hypercholesterolemia, n (%) 0.001 9 (26) 42 (60) Hypertension, n (%) 0.12 24.0 3.1 25.1 3.3 Body-Mass Index, kg/m 2 0.11 59.5 8.9 62.4 8.5 Age, years P Value Controls (N=35) CAD (N=70) Characteristic
- 10. Vascular Assessments of Study Population 0.008 14 (40) 47 (67) Carotid plaque (%) 0.32 0.96 0.14 1.01 0.28 mmIMT (mm) 0.003 5.18 2.69 3.56 2.41 FMD (%) P Value Controls (N=35) CAD (N=70)
- 11. Correlations between FRS and Vascular Markers r= 0.314, p=0.001 r= -0.246, p=0.016 r= -0.226, p=0.026
- 12. Diagnostic Values of FRS & Vascular Markers According to Specified Cut-off Values 54.5 80.7 68.6 69.7 - 0.000 0.69 FRS + mmIMT 1.05 47.3 80.9 74.3 56.7 2.50 0.007 0.66 FRS 83.3 82.3 81.2 81.4 80 .0 77.0 79.1 PPV 71.4 68.6 62.9 68.6 82.9 60.0 60.0 SP 60.0 81.5 4.75 0.001 0.70 FMD, % 66.7 81.0 - 0.000 0.75 FRS + FMD 4.75 + Carotid Plaque 61.0 75.8 - 0.000 0.73 FRS + Carotid plaque + mmIMT 1.05 66.7 83.6 - 0.000 0.72 FRS + Carotid Plaque 61.5 76.2 - 0.000 0.78 FRS + FMD 4.75 39.2 34.8 1.05 0.492 0.54 mm IMT, mm 47.7 67.1 - 0.033 0.64 Carotid plaque NPV SN Cut-off values P Value AUC Marker
- 13. Incremental Benefit of Vascular Markers in Addition to FRS for Coronary Risk Prediction FRS, AUC=0.66 FRS + Carotid plaque, AUC=0.72 (P=0.008 vs. FRS) FRS + FMD ≤4.75%, AUC=0.78 (P=0.007 vs. FRS) 1-Specificity Sensitivity 0.0 0.2 0.4 0.6 0.8 1.0 0.0 0.2 0.4 0.6 0.8 1.0
- 14. Univariate and Multivariate Predictors of an Acute Coronary Event 0.001 4.33 (1.77-10.62) Hypertension 0.003 4.80 (1.67-13.65) 0.000 5.28 (2.20-12.68) Hypercholesterolemia 0.27 1.58 (0.70-3.59) Smoking 0.009 3.07 (1.32-7.10) Carotid plaque 0.066 2.58 (0.94-7.07) mmIMT 1.05mm <0.001 7.97 (2.69-23.59) <0.001 6.63 (2.64-16.66) FMD 4.75% 0.034 1.45 (1.03-2.05) 0.006 1.50 (1.13-2.00) FRS P Value OR (95% CI) P Value OR (95% CI) Multivariable Univariable Risk Variables