Coronary Heart Disease (2-year risk) – First Event

Coronary Heart Disease
(2-year risk) – First Event

Based on
D’Agostino RB, Russell MW, Huse DM, Ellison RC, Silbershatz H, Wilson PW, Hartz SC. Primary and subsequent coronary risk appraisal: new results from the Framingham study. American heart journal. 2000 Feb 1;139(2):272-81. PMID:10650300.

Outcome
First Coronary Heart Disease

Duration of follow-up
Maximum of 4 years, 2-year risk prediction score sheets

Population of interest
Individuals free of all of the following CVDs before examination:

  • CHD (includes myocardial infarction, coronary insufficiency, and angina pectoris)
  • stroke (ischemic or hemorrhagic)
  • transient ischemic attack
  • congestive heart failure
  • intermittent claudication

Predictors

  • Age
  • Systolic blood pressure (SBP)
  • Cigarette smoking status (1 if current smoker, 0 otherwise)
  • Fasting lipid level (totals and HDL Cholesterol)
  • Physician diagnosis of diabetes at the current or a previous examination
  • Use of antihypertensive medication (yes/no)

Men: 2-year risk of first CHD event in individuals 35-74 years of age free of CVD at baseline

Age Points
35 – 39 0
40 – 44 1
45 – 49 3
50 – 54 4
55 – 59 6
60 – 64 7
65 – 69 9
70 – 74 10
HDL-C
Total-C 25 30 35 40 45 50 60 70 80
160 8 7 5 5 4 3 2 1 0
170 8 7 6 5 4 4 2 1 0
180 9 7 6 5 5 4 3 2 1
190 9 8 7 6 5 4 3 2 1
200 9 8 7 6 5 5 3 2 1
210 10 8 7 6 6 5 4 3 2
220 10 9 8 7 6 5 4 3 2
230 10 9 8 7 6 6 4 3 2
240 10 9 8 7 7 6 5 4 3
250 11 9 8 8 7 6 5 4 3
260 11 10 9 8 7 6 5 4 3
270 11 10 9 8 7 7 5 4 3
280 11 10 9 8 8 7 6 5 4
290 12 10 9 9 8 7 6 5 4
300 12 11 10 9 8 7 6 5 4
Diabetes Cigs
No 0 No 0
Yes 3 Yes 4
SBP
if untreated if treated
<110 0 <110 0
110-124 1 110-114 1
125-144 2 115-124 2
145-164 3 125-134 3
165-184 4 135-144 4
185-214 5 145-154 5
≥215 6 155-215 6
≥215 6
Pts 2-yr
Probabilities		 Pts 2-yr
Probabilities		 Pts 2-yr
Probabilities
0 0% 14 1% 28 17%
2 0% 16 2% 30 24%
4 0% 18 3% 32 32%
6 0% 20 4% 34 43%
8 0% 22 6%
10 1% 24 9%
12 1% 26 12%

Women: 2-year risk of first CHD event in individuals 35-74 years of age free of CVD at baseline

If-not-Menpausal
Age Points
35 – 39 0
40 – 44 1
45 – 49 3
50 – 54 4
55 – 59 6
60 – 64 7
65 – 69 9
70 – 74 10
HDL-C
Total-C 25 30 35 40 45 50 60 70 80
160 5 4 3 3 2 2 1 1 0
170 5 4 4 3 3 2 1 1 0
180 5 5 4 3 3 2 2 1 0
190 5 5 4 4 3 3 2 1 1
200 6 5 4 4 3 3 2 1 1
210 6 5 5 4 3 3 2 2 1
220 6 5 5 4 4 3 2 2 1
230 6 6 5 4 4 3 3 2 1
240 6 6 5 5 4 4 3 2 2
250 7 6 5 5 4 4 3 2 2
260 7 6 5 5 4 4 3 3 2
270 7 6 6 5 5 4 3 3 2
280 7 6 6 5 5 4 3 3 2
290 7 6 6 5 5 4 4 3 2
300 7 7 6 5 5 5 4 3 3
If Menpausal
Age Points
35 – 49 17
50 – 74 16
Diabetes Cigs
No 0 No 0
Yes 3 Yes 2
SBP
if untreated if treated
<110 0 <114 0
110-114 1 115-124 2
115-124 2 125-134 3
125-134 3 135-144 4
135-154 4 145-154 5
155-164 5 155-164 6
165-184 6 165-194 7
185-194 7 195-214 8
195-214 8 215-234 9
215-234 9 ≥235 10
≥235 910
alcohol-oz/wk
0 – 4 0
6 – 40 -1
If-has-prevalent-menopause-use:
Pts 2-yr
Probabilities		 Pts 2-yr
Probabilities		 Pts 2-yr
Probabilities
0 0% 14 0% 28 3%
2 0% 16 0% 30 6%
4 0% 18 0% 32 11%
6 0% 20 0% 34 18%
8 0% 22 1% 36 31%
10 0% 24 1%
12 0% 26 2%
If-does-not-have-prevalent-menopause-use:
Pts 2-yr
Probabilities		 Pts 2-yr
Probabilities
0 0% 14 2%
2 0% 16 3%
4 0% 18 5%
6 0% 20 9%
8 0% 22 16%
10 1% 24 27%
12 1% 26 43%

Weibull Regression coefficients for direct estimation of risk of first CHD event

Men Women
Variable Without triglycerides With triglycerides
Intercept 12.7868 20.405 20.9717
Age -0.0405 -0.062 -0.0621
Menopause – -3.824 -3.8522
Age x menopause – 0.0717 0.0726
In (total cholesterol/HDL) -0.9494 -0.89 -0.6256
In (SBP) -1.0163 -2.361 -2.2449
Antihypertensive therapy/SBP interaction* -0.0161 -0.01 -0.098
Diabetes -0.4412 -0.573 -0.5243
Smoker -0.6042 -0.404 -0.3777
In-(triglycerides) – – -0.2688
Alcohol(cz/wk) – 0.0461 0.0529
Extreme value scale parameter 0.7764 0.7333 0.7467

*given as antihypertensive therapy * [(200-sbp)(sbp-110)/100]