title: Utility of Framingham Coronary Heart Disease Risk Score for predicting cardiac risk after stroke.
abstract: OBJECTIVE
  Coronary heart disease (CHD) is a major cause of mortality among stroke patients after the acute period. Simple risk stratification of stroke patients without known CHD may permit prompt implementation of CHD-specific management strategies for those who are at high risk for cardiac events. We assessed the utility of the Framingham Coronary Heart Disease Risk Score (FCRS) as a prognosticator in stroke patients without known CHD.
  
  
  METHODS
  Post hoc analysis of a trial dataset of 3509 recent ischemic stroke patients who were aged 35 years or older, recruited from 56 centers, and followed-up for 2 years. Patients were categorized as having known CHD, high FCRS (≥20%), and low/intermediate FCRS (<20%). The predictive values between baseline FCRS and primary (myocardial infarction [MI]), secondary (MI or vascular death), and tertiary (recurrent stroke) outcomes were assessed in multivariate analyses.
  
  
  RESULTS
  Rates of first MI at 2 years were 6.34%, 4.65%, and 1.44% for the known CHD, high FCRS, and low/intermediate FCRS groups. Compared with stroke patients with low/intermediate FCRS, individuals with high FCRS had a higher risk of MI (adjusted hazard ratio, 3.70; 95% confidence interval, 2.14-6.38) and MI or vascular death (adjusted hazard ratio, 2.21; 95% confidence interval, 1.48-3.28). High FCRS did not predict recurrent stroke.
  
  
  CONCLUSIONS
  Among patients with a recent ischemic stroke without known CHD, high FCRS was associated with a higher risk of MI and vascular death, but not stroke. FCRS could be a simple way to identify recent stroke patients who may benefit from additional CHD-specific management.
authors.affiliation: Department of Neurology, University of Southern California, Los Angeles, CA, USA. towfighi@usc.edu
authors.forename: Amytis
authors.initials: A
authors.lastname: Towfighi
authors.forename: Daniela
authors.initials: D
authors.lastname: Markovic
authors.forename: Bruce
authors.initials: B
authors.lastname: Ovbiagele
mesh_terms: D000328:Adult; D003327:Coronary Disease / Q000150:complications* / Q000453:epidemiology; D004311:Double-Blind Method; D005260:Female; D006710:Homocysteine / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000453:epidemiology; D011379:Prognosis; D012307:Risk Factors; D020521:Stroke / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D014815:Vitamins / Q000627:therapeutic use
chemical_list: D014815:Vitamins; D006710:Homocysteine