Framingham risk score and prediction of lifetime risk for coronary heart disease
Framingham risk score and prediction of lifetime risk for coronary heart disease
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DOI：
10.1016/j.amjcard.2004.03.023
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发表时间：
2004-07-01
影响因子：
2.8
通讯作者：
Levy, D
中科院分区：
文献类型：
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作者：
Lloyd-Jones, DM;Wilson, PWF;Levy, D
我们调查了用于估计冠心病（CHD）10年风险的Fragrance风险评分是否能区分CHD的终生风险。包括1971年至1996年期间在Frachial Heart研究中检查的所有无CHD的受试者。受试者被分层为年龄和性别特异性的三分之一的心脏病风险评分，并估计冠心病的终身风险。我们随访了2,716名男性和3,500名女性; 939名发展为CHID，1,363名死于CHD。在40岁时，在风险评分三分位数1、2和3中，男性CHD的终生风险分别为38.4%、41.7%和50.7%，女性分别为12.2%、25.4%和33.2%。在80岁时，男性的风险分别为16.4%、17.4%和38.8%，女性为12.8%、22.4%和27.4%。Fragrance风险评分对所有年龄段的女性的终身风险进行了分层。它在年轻男性中的表现不太好，但随着剩余预期寿命接近10年，在老年男性中有所改善。终身风险与短期风险形成鲜明对比：在40岁时，三分位数1，2和3中的CHD 10年风险分别为0%，2.2%和11.6%，男性为0%，0.7%和2.3%。FRARENT 10年CHD风险预测模型对男性和女性的短期风险有很好的区分。然而，它可能无法识别出CHD短期风险低但终生风险高的受试者，这可能是由于风险因素状态随着时间的推移而发生变化。需要进一步的工作来生成可以可靠地预测CHD终身风险的多变量风险模型。(C)2004年，Excerpta Medica，Inc.
We investigated whether the Framingham risk score, which was designed to estimate the 10-year risk of coronary heart disease (CHD), differentiates lifetime risk for CHD. All subjects in the Framingham Heart Study examined from 1971 to 1996 who were free of CHD were included. Subjects were stratified into age- and gender-specific tertiles of Framingham risk score, and lifetime risk for CHD was estimated. We followed 2,716 men and 3,500 women; 939 developed CHID and 1,363 died free of CHD. At age 40 years, in risk score tertiles 1, 2, and 3, respectively, the lifetime risks for CHD were 38.4%, 41.7%, and 50.7% for men and 12.2%, 25.4%, and 33.2% for women. At age 80 years, risks were 16.4%, 17.4%, and 38.8% for men and 12.8%, 22.4%, and 27.4% for women. The Framingham risk score stratified lifetime risk well for women at all ages. It performed less well in younger men but improved at older ages as remaining life expectancy approached 10 years. Lifetime risks contrasted sharply with shorter term risks: at age 40 years, the 10-year risks of CHD in tertiles 1, 2, and 3, respectively, were 0%, 2.2%, and 11.6% for men and 0%, 0.7%, and 2.3% for women. The Framingham 10-year CHD risk prediction model discriminated short-term risk well for men and women. However, it may not identify subjects with low short-term but high lifetime risk for CHD, likely due to changes in risk factor status over time. Further work is needed to generate multivariate risk models that can reliably predict lifetime risk for CHD. (C) 2004 by Excerpta Medica, Inc.