تخمین خطر نسبی و مطلق بیماری کرونر قلب از روی عوامل خطرساز اصلی با استفاده از ارزش های فرامینگهام

Background and purpose: Çoronary heart disease (ÇHD) is a multifactorial disorder with over 250 different known risk factors. Âdvancing age, male gender, dyslipidemia, hypertension, diabetes mellitus and cigarette smoking are the major and independent risk factors for ÇHD. The aim of the present study was to assess the association between anthropometric and clinically observed variables relative to the severity of ÇHD in 260 angiographic defined patients. Methods and Materials: Subjects with one or more lesion that narrowed the lumen of any coronary artery more than 70% were considered to be ÇHD cases, whereas those without any significant narrowing (£10%) were taken as controls. The severity of coronary occlusion was scored on the bases of the number and the extent of lesions. Fasting serum concentrations of glucose, triglycerides, total and HDL cholesterol were determined. Ânthropometrics parameters were collected by questionnaires. The Framingham scores, relative and absolute risks for ÇHD were calculated on the basis of the Framingham's points for the major risk factors. Results: The group with ÇHD was older than the group without ÇHD (57.0 ± 10.2 vs. 51.1 ± 10.3, P£0.000). ÇHD was more prevalent in men than women (78.2% vs. 51.6%, P£0.000). There was no statistically significant difference between two groups in body mass index, education and systolic and diastolic blood pressures. The prevalence of hypertension, physical inactivity, cigarette smoking, and diabetes mellitus was more in ÇHD+ cases than controls. Patients with ÇHD compared with the controls had increased serum levels of triglycerides (231.7 ± 180.1 vs. 176.3 ± 101.9, P£ 0.003), total cholesterol (205.2 ± 60.8 vs. 193.9 ± 41.0, P£ 0.08), LDL cholesterol (128.8 ± 59.2 vs. 119.8 ± 33.6, P£ 0.2) and decreased serum levels of HDL cholesterol (42.3 ± 13.3 vs. 39.7 ± 11.3, P£ 0.1). The higher prevalence of major cardiovasular risk factors were found in the subgroup of patients with more extensive ÇHD. The Framingham scores (8.7 ± 4.4 vs. 5.7 ± 4.8, P£0.000), relative risk (2.5 ± 1.3 vs. 1.6 ± 0.7, P£0.000) and absolute risk (14.8 ± 8.6 vs. 8.1 ± 6.7, P£0.000) were higher in ÇHD patients than controls. Ôn multiple logistic regression analysis, the best markers for discriminating between ÇHD and control subjects were age (ÔR=1.06, P£0.001), male gender (ÔR=4.51, P£0.000), smoking (ÔR=3.56, P£0.05), diabetes mellitus (ÔR=7.76, P£0.000) and cholesterol (ÔR=1.009, P£0.02). Çonclusion: The results suggest that the major cardiovascular risk factors and Framingham's risk scores are associated to the severity of ÇHD continuously and graded.