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弗雷明汉风险评分与冠状动脉疾病的严重程度

Framingham risk score and severity of coronary artery disease.

作者信息

Sayin M R, Cetiner M A, Karabag T, Akpinar I, Sayin E, Kurcer M A, Dogan S M, Aydin M

机构信息

Department of Cardiology, Faculty of Medicine, Bulent Ecevit University, 67600, Kozlu/Zonguldak, Turkey,

出版信息

Herz. 2014 Aug;39(5):638-43. doi: 10.1007/s00059-013-3881-4. Epub 2013 Jul 21.

Abstract

OBJECTIVES

Coronary artery disease (CAD) is a leading cause of morbidity and mortality worldwide. Easy-to-perform and reliable parameters are needed to predict the presence and severity of CAD and to implement efficient diagnostic and therapeutic modalities. We aimed to examine whether the Framingham risk scoring system can be used for this purpose.

METHODS

A total of 222 patients (96 women, 126 men; mean age, 59.1 ± 11.9 years) who underwent coronary angiography were enrolled in the study. Presence of > %50 stenosis in a coronary artery was assessed as critical CAD. The Framingham risk score (FRS) was calculated for each patient. CAD severity was assessed by the Gensini score. The relationship between the FRS and the Gensini score was analyzed by correlation and regression analyses.

RESULTS

The mean Gensini score was 18.9 ± 25.8, the median Gensini score was 7.5 (0-172), the mean FRS was 7.7 ± 4.2, and the median FRS was 7 (0-21). Correlation analysis revealed a significant relationship between FRS and Gensini score (r = 0.432, p < 0.0001). This relationship was confirmed by linear regression analysis (β = 0.341, p < 0.0001). A cut-off level of 7.5 for FRS predicted severe CAD with a sensitivity of 68 % and a specificity of 73.6 % (ROC area under curve: 0.776, 95 % CI: 0.706-0.845, PPV: 78.1 %, NPV: 62.3 %, p < 0.0001).

CONCLUSION

Our work suggests that the FRS system is a simple and feasible method that can be used for prediction of CAD severity. As the sample size was small in our study, further large-scale studies are needed on this subject to draw solid conclusions.

摘要

目的

冠状动脉疾病(CAD)是全球发病和死亡的主要原因。需要易于执行且可靠的参数来预测CAD的存在和严重程度,并实施有效的诊断和治疗方式。我们旨在研究弗雷明汉风险评分系统是否可用于此目的。

方法

共有222例接受冠状动脉造影的患者(96名女性,126名男性;平均年龄59.1±11.9岁)纳入本研究。冠状动脉狭窄>50%被评估为重度CAD。为每位患者计算弗雷明汉风险评分(FRS)。CAD严重程度通过Gensini评分评估。通过相关性和回归分析来分析FRS与Gensini评分之间的关系。

结果

平均Gensini评分为18.9±25.8,Gensini评分中位数为7.5(0 - 172),平均FRS为7.7±4.2,FRS中位数为7(0 - 21)。相关性分析显示FRS与Gensini评分之间存在显著关系(r = 0.432,p < 0.0001)。线性回归分析证实了这种关系(β = 0.341,p < 0.0001)。FRS的截断值为7.5时,预测重度CAD的敏感性为68%,特异性为73.6%(曲线下面积:0.776,95%CI:0.706 - 0.845,阳性预测值:78.1%,阴性预测值:62.3%,p < 0.0001)。

结论

我们的研究表明FRS系统是一种可用于预测CAD严重程度的简单可行方法。由于我们研究中的样本量较小,需要就此主题开展进一步的大规模研究以得出确凿结论。

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