Raj Madhu P, Krishnamurthy Vishwanath, Basu Eilene, Balaji Vijay, Prakash Rao Varun Vinayak, R Nithin
Internal Medicine, Ramaiah Medical College, Bangalore, IND.
Cureus. 2023 Jan 1;15(1):e33221. doi: 10.7759/cureus.33221. eCollection 2023 Jan.
The prevalence of myocardial infarction (MI) among young Indian adults is on the rise with reports suggesting 32.7% of all deaths in men and 32.6% of all deaths in women between 2010-13 were due to cardiovascular diseases (CVDs). Though various long-term cohort studies have established risk assessment scores none of them are specific to the Indian population. In this study, we look to establish which scoring system among the American College of Cardiology (ACC), Joint British Society (JBS3) and Framingham Risk Scores (FRS) would be reliable for the Indian population. A timely intervention based on the most reliable score can help mitigate cardiovascular diseases.
In this cross-sectional study, we included Indian adults, aged more than 40 years, with first MI. Patients previously on lipid lowering drugs were excluded. Demographic data, history, clinical information, laboratory data and other investigations were noted. Subsequently the predicted cardiovascular risk scores based on JBS3, ACC, and FRS were calculated and divided into low risk, intermediate and high risk based on the categorization of the risk scores individually.
There were 102 (79.1%) males and 23 (17.8%) females with a mean age of 51.01 years (standard deviation [SD]=12.82, p value <0.001). There was considerable prevalence of type 2 diabetes mellitus with 56 (47.1%) of the subjects being known diabetics. The mean 10-year risk of MI based on ACC was 12.42% (SD=10.45), mean JBS3 score was 14.45% (SD=12.67) and mean FRS score was 15.75% (SD=14.71). FRS scores when categorized, 48 (40.3%) patients had low risk, 30 (23.3%) had medium risk and 43 (33.3%) had high risk. As for ACC score, 39 (35.8%) patients were in low risk and 29 (26.6%) in intermediate risk, borderline in 18 (16.5%) and high risk in 23 (21.1%). In JBS3 scores, 53 (46.5%) patients were in low risk, 32 (28.1%) were in moderate risk and 29 (25.4%) in high risk.
The absolute value of 10-year risk scores was highest for FRS scores. The proportion of patients whose scores were under the category of high risk was highest for FRS.
印度年轻成年人中心肌梗死（MI）的患病率呈上升趋势，报告显示2010 - 2013年间男性所有死亡病例中有32.7%、女性所有死亡病例中有32.6%归因于心血管疾病（CVD）。尽管各种长期队列研究已经建立了风险评估分数，但没有一个是针对印度人群的。在本研究中，我们旨在确定美国心脏病学会（ACC）、英国联合协会（JBS3）和弗雷明汉风险评分（FRS）中的哪种评分系统对印度人群是可靠的。基于最可靠分数的及时干预有助于减轻心血管疾病。
在这项横断面研究中，我们纳入了年龄超过40岁的首次发生心肌梗死的印度成年人。排除先前服用降脂药物的患者。记录人口统计学数据、病史、临床信息、实验室数据和其他检查结果。随后，根据JBS3、ACC和FRS计算预测的心血管风险分数，并根据各个风险分数的分类分为低风险、中风险和高风险。
共有102名男性（79.1%）和23名女性（17.8%），平均年龄为51.01岁（标准差[SD]=12.82，p值<0.001）。2型糖尿病的患病率相当高，56名（47.1%）受试者为已知糖尿病患者。基于ACC的10年心肌梗死平均风险为12.42%（SD=10.45），JBS3平均评分为14.45%（SD=12.67），FRS平均评分为15.75%（SD=14.71）。FRS分数分类时，48名（40.3%）患者为低风险（low risk），30名（23.3%）为中风险（medium risk），43名（33.3%）为高风险（high risk）。至于ACC分数，39名（35.8%）患者为低风险，29名（26.6%）为中风险，18名（16.5%）为临界风险（borderline），23名（21.1%）为高风险。在JBS3分数中，53名（46.5%）患者为低风险，32名（28.1%）为中度风险（moderate risk），29名（25.4%）为高风险。
FRS分数的10年风险分数绝对值最高。FRS分数处于高风险类别下的患者比例最高。
