Document Detail

Framingham risk score inadequately predicts cardiac risk in young patients presenting with a first myocardial infarction.
MedLine Citation:
PMID:  20372749     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: The Framingham Risk Score (FRS) is a well-validated epidemiologic tool used to assess the risk for a fi rst cardiac event. Because young patients presenting with a fi rst myocardial infarction (MI) tend to have less significant risk profiles compared with older patients, we hypothesized that FRS may underestimate cardiac risk in these patients. MATERIALS AND METHODS: We studied 1267 patients between January 2002 and November 2007 presenting with a fi rst MI. Patients with pre-existing diabetes mellitus and vascular disease were excluded. FRS was calculated for each patient. Patients were divided based on their age: group A (<40 years), group B (40 to 64 years) and group C (> or =65 years). RESULTS: The mean age was 54.7 +/- 11 years, 88.4% of the patients were males. Younger patients were more likely to be assigned with lower scores. Based on FRS, 63.0%, 29.3% and 14.2% of group A, B and C patients were classified as low risk (10-year risk for cardiac events<10%) respectively, P <0.001. The sensitivity of FRS in identifying at least intermediate risk subjects (10-year risk for cardiac events >10%) was 37.0% in group A vs 85.8% in group C (P <0.001). The incidence of newly diagnosed diabetes mellitus was higher in younger patients (12.0% vs 13.2% vs 7.1 % in groups A, B and C respectively, P = 0.027). CONCLUSIONS: FRS inadequately predicts cardiac risk in young patients presenting with a fi rst MI. This could be because a significant proportion of these young patients have undiagnosed diabetes mellitus, a coronary artery disease risk equivalent.
Glenn K M Lee; Li-Ching Lee; Christopher W Y Liu; Shir Lynn Lim; Lu-Ming Shi; Hean-Yee Ong; Yean-Teng Lim; Tiong-Cheng Yeo
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of the Academy of Medicine, Singapore     Volume:  39     ISSN:  0304-4602     ISO Abbreviation:  Ann. Acad. Med. Singap.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-04-07     Completed Date:  2010-08-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7503289     Medline TA:  Ann Acad Med Singapore     Country:  Singapore    
Other Details:
Languages:  eng     Pagination:  163-7     Citation Subset:  IM    
Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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MeSH Terms
Age Factors
Diabetes Complications*
Middle Aged
Myocardial Infarction / complications*,  diagnosis
Retrospective Studies
Risk Assessment
Risk Factors
Sex Factors

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