Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2011;64:305-11 - Vol. 64 Num.04 DOI: 10.1016/j.rec.2010.11.006

Clinical Applicability of the Framingham 30-Year Risk Score. Usefulness in Cardiovascular Risk Stratification and the Diagnosis of Carotid Atherosclerotic Plaque

Walter Masson a,, Daniel Siniawski a, Juan Krauss a, Arturo Cagide a

a Servicio de Cardiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

Keywords

Primary prevention. Cardiovascular risk scores. Carotid arteries. Atherosclerotic plaque.

Abstract

Introduction and objectives

The traditional Framingham score underestimates cardiovascular risk in certain populations. Extending its time-scale to 30 years and assessing its relationship with the presence of carotid atherosclerotic plaque may improve risk stratification. The objectives were: a) to determine the percentage of patients previously classified with the traditional score who were reclassified when using Framingham 30-year risk score; b) to analyze the prevalence of carotid atherosclerotic plaque; and c) to determine the diagnostic potential of the 30-year score to detect carotid plaque.

Methods

A carotid Doppler ultrasound study was performed and the Framingham 10-year risk score and 30-year score (based on lipids and body mass index) for “hard” cardiovascular events were calculated in a population of primary prevention patients. Prevalence of carotid plaque was determined. Receiver operating characteristic analysis was conducted.

Results

In total, 305 subjects were included (age 48 [11] years, 52% men). The 30-year scores based on lipids and on body mass index reclassified 70% and 63% of the population, respectively. Prevalence of carotid plaque was 28.5% and associated gradually with risk category. The area under the curve and optimal cutoff points of the 30-year score to detect carotid plaque were 0.862 and 26% (based on lipids) and 0.845 and 22% (based on body mass index), respectively.

Conclusions

The 30-year score reclassified a large number of patients and discriminated between those with or without evidence of carotid plaque.

1885-5857/© 2011 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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