A Simple Modified Framingham Scoring System to Predict Obstructive Coronary Artery Disease
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Development of simple non-invasive risk prediction model would help in early prediction of coronary artery disease (CAD) reducing the burden on public health. This paper demonstrates a risk prediction scoring system to predict obstructive coronary artery disease (OCAD) in CAD patients. A total of 13,082 patients, referred for coronary angiography (CAG) in TRUST trial, were included in the development of a multivariable diagnostic prediction model. External validation of the model used 1009 patients from PRECOMIN study. The occurrence of OCAD was observed in 73.1% and 75.1% patients in TRUST (development) and PRECOMIN study (validation) cohorts, respectively. Good discrimination and calibration were obtained in both development and validation datasets (C-statistics 0.686 and 0.677; Hosmer–Lemeshow χ2 = 5.19, p = 0.74 and χ2 = 8.60, p = 0.38, respectively). The simple risk prediction model and risk scoring system developed on the basis of routine clinical variables showed good performance for estimation of OCAD in relative high-risk patients with suspected CAD.
KeywordsPrediction model Risk factors Coronary artery disease China Validation
Area under the curve
Body mass index
Coronary artery disease
Chinese Multi-Provincial Cohort study
Chinese ethics committee of registering clinical trials
Diastolic blood pressure
Fully conditional specification
Family history of CAD
Framingham risk score
High-density lipoproteins cholesterol
Low-density lipoproteins cholesterol
Low- and middle-income countries
Left ventricular ejection fraction
Markov Chain Monte Carlo
Obstructive coronary artery disease
Percutaneous coronary intervention
Predictive value of contrast volume to creatinine clearance ratio
Systolic blood pressure
The Safety and Tolerability of Ultravist in Patients Undergoing Cardiac Catheterization
The authors acknowledge Dr. Priyanka Nair and Dr. Anuradha Nalli from Indegene Pvt. Ltd. for medical writing assistance during the development of this manuscript.
SC, YL, JC, and QL: conception or design of the work; SC, YL, QL and XW: acquisition, analysis, or interpretation of data. SC, YL, QL, and XW: drafting the work or revising it critically for important intellectual content. SC, YL, XW, YZ, QG, JC, QL, and NT: final approval of the version published. All authors agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
The development of this manuscript was funded by Bayer. This work was supported by the Guangdong Provincial Cardiovascular Clinical Medicine Research Fund (grant number 2009X41 to Y.L. and N.T.), Science and Technology Planning Project of Guangdong Province (PRECOMIN study by Y.L. in 2011 and the study grant number 2014B070706010 to JY.C.), and the Guangdong Cardiovascular Institute and Cardiovascular Research Foundation Project of Chinese Medical Doctor Association (grant number SCRFCMDA201216 to JY.C.).
Compliance with Ethical Standards
Ethics Approval and Consent to Participate
The TRUST study (NCT01206257) and PRECOMIN study (NCT01400295) conformed to the principles of Declaration of Helsinki and were approved by the Chinese ethics committee of registering clinical trials (ChiECRCT) as the leading ethics board and additionally by the local ethics boards of each participating center. All patients gave their written informed consent prior to enrollment.
Consent for Publication
Conflict of Interest
The authors declare that they have no competing interests.
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