Cardiovascular risk assessment in the metabolic syndrome: results from the Prospective Cardiovascular Munster (PROCAM) Study
Cardiovascular risk assessment in the metabolic syndrome: results from the Prospective Cardiovascular Munster (PROCAM) Study
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DOI：
10.1038/ijo.2008.29
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发表时间：
2008-05-01
影响因子：
4.9
通讯作者：
Seedorf, U.
中科院分区：
文献类型：
--
作者：
Assmann, G.;Schulte, H.;Seedorf, U.
目的：我们的目的是(1)构建一个改进的PROCAM风险算法，该算法将BMI/腰围纳入预测冠状动脉事件的模型；(2)评估该方法与先前建立的PROCAM风险算法预测代谢综合征患者冠状动脉风险的准确性。设计：前瞻性心血管明斯特（PROCAM）研究，一项在德国西北部工作的男性和女性的前瞻性研究。研究对象：共有7134名年龄在35-65岁之间的男性。测量方法：在随访10年内发生的404例主要冠状动脉事件（定义为非致死性心肌梗死和冠状动脉死亡）的基础上，通过将BMI/腰围作为预测冠状动脉事件的Cox比例风险模型中的固定变量，构建了改进的PROCAM风险算法。代谢综合征是根据NCEP-ATP III专家组提出的最新建议定义的。结果：被归类为代谢综合征的男性（n = 2325，患病率：32.6%）在10年内发生主要冠状动脉事件的可能性是没有代谢综合征的男性的2.59倍。在患有代谢综合征的男性中，观察到的主要冠状动脉事件发生率为9.6%，与根据改进的基于bmi的PROCAM风险算法估计的总体风险（10.2%）相吻合。与先前发表的完全调整后的PROCAM算法进行的比较计算得出了非常相似的结果。结论：两种PROCAM算法提供了非常准确的方法来确定男性代谢综合征患者的冠状动脉风险。
Objectives: We aimed (1) to construct a modified PROCAM risk algorithm, which incorporates BMI/waist circumference in a model for predicting coronary events; (2) to evaluate how accurate this and the previously established PROCAM risk algorithm predict coronary risk in individuals with metabolic syndrome.Design: Prospective Cardiovascular Munster (PROCAM) Study, a prospective study of men and women at work in the northwest of Germany.Subjects: A total of 7134 men aged 35-65 years at study entry.Measurements: On the basis of 404 major coronary events (defined as nonfatal MI and coronary deaths), which occurred within 10 years of follow-up, a modified PROCAM risk algorithm was constructed by incorporating BMI/waist circumference as fixed variable in a Cox proportional hazards model for predicting coronary events. The metabolic syndrome was defined according to the latest recommendations proposed by the NCEP-ATP III Panel.Results: Men who were classified as having the metabolic syndrome (n = 2325, prevalence: 32.6%) were 2.59-fold more likely to experience a major coronary event within 10 years of follow-up than men not having the metabolic syndrome. In men with metabolic syndrome, the observed major coronary event rate of 9.6% corresponded well with their estimated global risk according to the modified BMI-based PROCAM risk algorithm (10.2%). Comparative calculations performed with the previously published fully adjusted PROCAM algorithm yielded very similar results.Conclusion: Both PROCAM algorithms provide very accurate means to ascertain coronary risk in male patients with metabolic syndrome.