title: Impact of Framingham risk score, flow-mediated dilation, pulse wave velocity, and biomarkers for cardiovascular events in stable angina.
abstract: Although the age-adjusted Framingham risk score (AFRS), flow-mediated dilation (FMD), brachial-ankle pulse wave velocity (baPWV), high-sensitivity C-reactive protein (hsCRP), fibrinogen, homocysteine, and free fatty acid (FFA) can predict future cardiovascular events (CVEs), a comparison of these risk assessments for patients with stable angina has not been reported. We enrolled 203 patients with stable angina who had been scheduled for coronary angiography (CAG). After CAG, 134 patients showed significant coronary artery disease. During 4.2 yr follow-up, 36 patients (18%) showed CVEs, including myocardial infarction, de-novo coronary artery revascularization, in-stent restenosis, stroke, and cardiovascular death. ROC analysis showed that AFRS, FMD, baPWV, and hsCRP could predict CVEs (with AUC values of 0.752, 0.707, 0.659, and 0.702, respectively, all P<0.001 except baPWV P=0.003). A Cox proportional hazard analysis showed that AFRS and FMD were independent predictors of CVEs (HR, 2.945; 95% CI, 1.572-5.522; P=0.001 and HR, 0.914; 95% CI, 0.826-0.989; P=0.008, respectively). However, there was no difference in predictive power between combining AFRS plus FMD and AFRS alone (AUC 0.752 vs. 0.763; z=1.358, P=0.175). In patients with stable angina, AFRS and FMD are independent predictors of CVEs. However, there is no additive value of FMD on the AFRS in predicting CVEs.
authors.affiliation: Cardiovascular Division, Department of Internal Medicine, Hallym University Medical Center, Anyang, Korea.
authors.forename: Kyoung-Ha
authors.identifier: 0000-0002-5935-8715
authors.initials: KH
authors.lastname: Park
authors.affiliation: Cardiovascular Division, Department of Internal Medicine, Hallym University Medical Center, Anyang, Korea.
authors.forename: Sang Jin
authors.identifier: 0000-0003-4451-468X
authors.initials: SJ
authors.lastname: Han
authors.affiliation: Cardiovascular Division, Department of Internal Medicine, Hallym University Medical Center, Anyang, Korea.
authors.forename: Hyun-Sook
authors.identifier: 0000-0002-7469-7993
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Cardiovascular Division, Department of Internal Medicine, Hallym University Medical Center, Anyang, Korea.
authors.forename: Min-Kyu
authors.identifier: 0000-0002-1873-6513
authors.initials: MK
authors.lastname: Kim
authors.affiliation: Cardiovascular Division, Department of Internal Medicine, Hallym University Medical Center, Anyang, Korea.
authors.forename: Sang Ho
authors.identifier: 0000-0002-2063-1542
authors.initials: SH
authors.lastname: Jo
authors.affiliation: Cardiovascular Division, Department of Internal Medicine, Hallym University Medical Center, Anyang, Korea.
authors.forename: Sung-Ai
authors.identifier: 0000-0002-3411-0529
authors.initials: SA
authors.lastname: Kim
authors.affiliation: Cardiovascular Division, Department of Internal Medicine, Hallym University Medical Center, Anyang, Korea.
authors.forename: Woo Jung
authors.identifier: 0000-0003-3896-5169
authors.initials: WJ
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D060050:Angina, Stable / Q000503:physiopathology*; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D001783:Blood Flow Velocity; D003324:Coronary Artery Disease / Q000175:diagnosis*; D004730:Endothelium, Vascular; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011673:Pulsatile Flow; D063177:Pulse Wave Analysis / Q000379:methods*; D012372:ROC Curve; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D015415:Biomarkers
keywords: Cardiovascular Event; Flow-Mediated Dilation; Framingham Risk Score