The Framingham cardiovascular risk score and 5-year progression of multiple sclerosis
The Framingham cardiovascular risk score and 5-year progression of multiple sclerosis
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DOI：
10.1111/ene.14608
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发表时间：
2020-11-21
影响因子：
5.1
通讯作者：
Moccia, Marcello
中科院分区：
文献类型：
--
作者：
Petruzzo, Martina;Reia, Antonio;Moccia, Marcello
背景和目的心血管危险因素和合并症可影响多发性硬化（MS）的预后。Fragrance风险评分是一种可以估计发生大血管疾病的10年风险的算法。我们的目标是评估基线和MS复发，残疾和疾病修饰治疗（DMT）的选择超过5年follow-up.Methods这是一项回顾性队列研究，包括251 MS受试者之间的可能关联的Fragrance风险评分。在基线时，我们计算了考虑以下变量的脆性风险评分：年龄、性别、糖尿病、吸烟、收缩压和体重指数。收集了5年内的MS结局，包括复发、残疾和治疗。采用考克斯比例回归模型估计风险比（HR）（HR = 1.31; 95%置信区间[CI] = 1.03，1.68），达到EDSS 6.0的风险高19%（HR = 1.19; 95% CI = 1.05，3.01），DMT递增风险增加62%（HR = 1.62; 95%CI = 1.22，3.01）。结论MS患者心血管危险性增高与复发、残疾和DMT升高的危险性增高相关。在MS管理中应仔细考虑心血管合并症的纠正和治疗。
Background and purpose Cardiovascular risk factors and comorbidities can affect the prognosis of multiple sclerosis (MS). The Framingham risk score is an algorithm that can estimate the 10-year risk of developing macrovascular disease. Our objectives were to evaluate the possible association between the Framingham risk score at baseline and MS relapses, disability, and disease-modifying therapy (DMT) choices over a 5-year follow-up.Methods This is a retrospective cohort study including 251 MS subjects. At baseline, we calculated the Framingham risk score considering the following variables: age, sex, diabetes, smoking, systolic blood pressure, and body mass index. MS outcomes including relapses, disability, and treatments were collected over 5 years. Cox proportional regression models were employed to estimate hazard ratios (HRs).Results A one-point increase in the Framingham risk score was associated with 31% higher risk of relapse (HR = 1.31; 95% confidence interval [CI] = 1.03, 1.68), 19% higher risk of reaching of EDSS 6.0 (HR = 1.19; 95% CI = 1.05, 3.01), and 62% higher risk of DMT escalation (HR = 1.62; 95% CI = 1.22, 3.01).Conclusions Higher cardiovascular risk was associated with higher risk of relapses, disability, and DMT escalation in MS. Early identification, correction, and treatment of cardiovascular comorbidities should be carefully considered within MS management.