Recurrent Coronary Heart Disease

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
Subsequent CHD (includes mostly hospitalized events consisting of myocardial infarction, coronary insufficiency, angina pectoris, and sudden and non-sudden coronary death)

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

Population of interest
Individuals who had at least one CHD event or ischemic stroke before examination and survived the acute stage of that event.

Predictors

Age
Systolic blood pressure (SBP)
Cigarette smoking status (1 if current smoker, 0 otherwise)
Fasting lipid level (total and HDL cholesterol)
Physician diagnosis of diabetes at the current or a previous examination

Men: 2-year risk of recurring CHD

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	10	9	7	6	5	4	3	1	0
170	11	9	8	7	6	5	3	2	1
180	11	10	8	7	6	5	4	2	1
190	12	10	9	8	7	6	4	3	2
200	12	11	9	8	7	6	5	3	2
210	13	11	10	9	7	7	5	4	2
220	13	11	10	9	8	7	5	4	3
230	13	12	10	9	8	7	6	4	3
240	14	12	11	10	9	8	6	5	4
250	14	13	11	10	9	8	6	5	4
260	15	13	12	10	9	8	7	5	4
270	15	13	12	11	10	9	7	6	5
280	15	14	12	11	10	9	7	6	5
290	16	14	13	11	10	9	8	6	5
300	16	14	13	12	11	10	8	7	6

Diabetes
No	0
Yes	4

Pts	2-yr Probabilities	Pts	2-yr Probabilities	Pts	2-yr Probabilities
0	3%	14	9%	28	25%
2	4%	16	11%	30	29%
4	4%	18	13%
6	5%	20	14%
8	6%	22	17%
10	7%	24	19%
12	8%	26	22%

Women: 2-year risk of recurring CHD

Age	Points
35 – 39	0
40 – 44	1
45 – 49	2
50 – 54	3
55 – 59	4
60 – 64	5
65 – 69	6
70 – 74	7

HDL-C
Total-C	25	30	35	40	45	50	60	70	80
160	10	9	7	6	5	4	3	1	0
170	11	9	8	7	6	5	3	2	1
180	11	10	8	7	6	5	4	2	1
190	12	10	9	8	7	6	4	3	2
200	12	11	9	8	7	6	5	3	2
210	13	11	10	9	8	7	5	4	2
220	13	12	10	9	8	7	5	4	3
230	14	12	11	9	8	7	6	4	3
240	14	12	11	10	9	8	6	5	4
250	14	13	11	10	9	8	7	5	4
260	15	13	12	11	9	9	7	6	4
270	15	13	12	11	10	9	7	6	5
280	15	14	12	11	10	9	8	6	5
290	16	14	13	12	10	10	8	7	5
300	16	14	13	12	11	10	8	7	6

Diabetes		Cigs
No	0	No	0
Yes	3	Yes	4

SBP
<110	0
110-114	1
115-124	3
125-134	4
135-144	5
145-154	6
155-164	7
165-184	8
185-194	9
195-214	10
215-224	11
225-244	12
245+	13

Pts	2-yr Probabilities	Pts	2-yr Probabilities	Pts	2-yr Probabilities
0	1%	14	3%	28	9%
2	1%	16	3%	30	11%
4	1%	18	4%	32	13%
6	1%	20	5%	34	16%
8	2%	22	5%	36	19%
10	2%	24	7%	38	22%
12	2%	26	8%

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

Variable	Men	Women
Intercept	4.995	13.537
Age	-0.0145	-0.0225
In (total cholesterol/HDL)	-0.6738	-0.834
In (SBP)	–	-1.3713
Diabetes	-0.3042	-0.7829
Smoker	–	-0.3669
Extreme Value Parameter	0.9994	1.0313