The association of Framingham and Reynolds risk scores with incidence and progression of coronary artery calcification in MESA (Multi-Ethnic Study of Atherosclerosis).
The association of Framingham and Reynolds risk scores with incidence and progression of coronary artery calcification in MESA (Multi-Ethnic Study of Atherosclerosis).
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弗雷明汉和雷诺的关系风险评分与台带冠状动脉钙化的发生率和进展（动脉粥样硬化的多种族研究）。
DOI：
10.1016/j.jacc.2011.08.022
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发表时间：
2011-11-08
影响因子：
24
通讯作者：
Nasir, Khurram
中科院分区：
文献类型：
--
作者：
DeFilippis, Andrew P.;Blaha, Michael J.;Ndumele, Chiadi E.;Budoff, Matthew J.;Lloyd-Jones, Donald M.;McClelland, Robyn L.;Lakoski, Susan G.;Cushman, Mary;Wong, Nathan D.;Blumenthal, Roger S.;Lima, Joao;Nasir, Khurram
关键词：
比较Framingham风险评分（FRS）和Reynolds风险评分（RRS）与亚临床动脉粥样硬化的关系，通过冠状动脉钙（CAC）的发生率和进展进行评估。竞争风险算法在识别亚临床动脉粥样硬化方面的相对有效性尚不清楚。动脉粥样硬化多民族研究（MESA）是一项前瞻性队列研究，共有6814名无基线心血管疾病的参与者。所有参与者都接受了风险因素评估，以及基线和随访CAC检测。我们使用相对风险和稳健线性回归评估了FRS和RRS预测CAC发病率和进展的性能。研究人群包括5140人（61±10岁，男性占47%，平均随访时间3.1±1.3年）。在53%没有基线CAC的受试者（n= 2729）中，18% （n=510）发生了偶发性CAC。FRS和RRS均可显著预测CAC的发生[RR分别为1.40 （95% CI 1.29 - 1.52）和1.41 (95% CI 1.30 - 1.54) /风险增加5%]和CAC进展[平均CAC评分变化6.92 （95% CI 5.31 - 8.54）和6.82 (95% CI 5.51 - 8.14) /风险增加5%]。13.7%的患者存在风险分类不一致（10年冠心病风险<或> 10%），只有RRS一致地增加了CAC发病率和进展的预测价值。这些亚临床动脉粥样硬化的发现得到了5.6±0.7年随访期冠心病事件分析的支持。RRS和FRS均可预测亚临床动脉粥样硬化的发生和进展。然而，当评分系统之间存在不一致时，RRS可能提供额外的预测信息。
To compare the association of the Framingham Risk Score (FRS) and Reynolds Risk Score (RRS) with subclinical atherosclerosis, assessed by incidence and progression of coronary artery calcium (CAC). The comparative effectiveness of competing risk algorithms for indentifying subclinical atherosclerosis is unknown. The Multi-Ethnic Study of Atherosclerosis (MESA) is a prospective cohort study of 6,814 participants free of baseline CVD. All participants underwent risk factor assessment, as well as baseline and follow-up CAC testing. We assessed the performance of the FRS and RRS to predict CAC incidence and progression using relative risk and robust linear regression. The study population included 5,140 individuals (61±10 years, 47% males, mean follow-up: 3.1±1.3 years). Among 53% of subjects (n=2,729) with no baseline CAC, 18% (n=510) developed incident CAC. Both the FRS and RRS were significantly predictive of incident CAC [RR 1.40 (95% CI 1.29 – 1.52), and RR 1.41 (95% CI 1.30 – 1.54) per 5% increase in risk, respectively] and CAC progression [mean CAC score change 6.92 (95% CI 5.31 – 8.54) and 6.82 (95% CI 5.51 – 8.14) per 5% increase]. Discordance in risk category classification (< or > 10% 10-year CHD risk) occurred in 13.7%, with only the RRS consistently adding predictive value for incidence and progression of CAC. These subclinical atherosclerosis findings are supported by a CHD events analysis over 5.6±0.7 year follow-up. Both the RRS and FRS predict onset and progression of subclinical atherosclerosis. However, the RRS may provide additional predictive information when discordance between the scoring systems exists.
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