Alaei Faradonbeh Nazanin, Nikaeen Fariborz, Akbari Mojtaba, Almasi Naser, Vakhshoori Mehrbod
General Practitioner, School of Medicine, Najafabad Branch, Islamic Azad University, Najafabad, Iran.
Associate Professor, Department of Cardiology, School of Medicine, Najafabad Branch, Islamic Azad University, Najafabad, Iran.
ARYA Atheroscler. 2018 Jul;14(4):163-168. doi: 10.22122/arya.v14i4.1685.
Risk assessment in clinical practice plays an important role in classifying population for appropriate preventive medicine for each category. Several multivariable risk predictor algorithms and inflammatory biomarkers are developed for assessing risk for cardiovascular diseases (CVDs). We aimed to depict a picture of the cardiovascular risk profiles in the Iranian population with diabetes mellitus (DM) through three risk predictors for the first time, as the patients with DM have an increased risk for CVDs.
In this cross-sectional study, the sample size consisted of 418 patients with DM from Diabetes Clinic of Shariati hospital, Isfahan, Iran, in February to July, 2014. We collected the latest information, and then calculated the 10-year CVD risk using Framingham risk score (FRS) and atherosclerotic cardiovascular disease (ASCVD) risk score; while high-sensitivity C-reactive protein (hs-CRP) was measured for them based on their physicians' prescription. Finally, all data were analyzed using SPSS software.
The mean 10-year risk prediction of CVDs in the 30- to 74-year-old Iranian patients with DM was high in all three predictors based on their cut-off points, 16.31%, 12.39%, and 3.46 mg/l for FRS, ASCVD risk score, and hs-CRP level, respectively. Although the mean FRS and ASCVD risk scores were significantly higher among men than women (P < 0.0500), the mean hs-CRP level was slightly lower in men than women (P > 0.0500).
Mean FRS and ASCVD risk scores and hs-CRP in patients were high, and a considerable proportion of patients with DM in our study were at intermediate and high risk for CVDs in the next 10 years. Future cohort studies would investigate the accuracy of different predictors in upcoming years, and also help to derive a specific model or recalibrate existing predictors with characteristic of Iranian populations and specific target groups.
临床实践中的风险评估在为不同人群分类以提供适当的预防医学措施方面发挥着重要作用。已经开发了几种多变量风险预测算法和炎症生物标志物来评估心血管疾病(CVD)的风险。由于糖尿病(DM)患者患CVD的风险增加,我们旨在首次通过三种风险预测指标描绘伊朗糖尿病患者的心血管风险概况。
在这项横断面研究中,样本量包括2014年2月至7月来自伊朗伊斯法罕沙里亚蒂医院糖尿病诊所的418例DM患者。我们收集了最新信息,然后使用弗雷明汉风险评分(FRS)和动脉粥样硬化性心血管疾病(ASCVD)风险评分计算10年CVD风险;同时根据医生的处方为他们测量高敏C反应蛋白(hs-CRP)。最后,使用SPSS软件对所有数据进行分析。
根据截断点,在30至74岁的伊朗DM患者中,所有三种预测指标的CVD平均10年风险预测都很高,FRS、ASCVD风险评分和hs-CRP水平分别为16.31%、12.39%和3.46mg/l。尽管男性的平均FRS和ASCVD风险评分显著高于女性(P<0.0500),但男性的平均hs-CRP水平略低于女性(P>0.0500)。
患者的平均FRS、ASCVD风险评分和hs-CRP较高,并且我们研究中的相当一部分DM患者在未来10年有患CVD的中高风险。未来的队列研究将在未来几年研究不同预测指标的准确性,也有助于推导特定模型或重新校准具有伊朗人群和特定目标群体特征的现有预测指标。