Journal of Cardiovascular Translational Research

, Volume 11, Issue 6, pp 495–502 | Cite as

A Simple Modified Framingham Scoring System to Predict Obstructive Coronary Artery Disease

  • Yong Liu
  • Qiang Li
  • Shiqun Chen
  • Xia Wang
  • Yingling Zhou
  • Ning Tan
  • Jiyan ChenEmail author
Original Article


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.


Prediction model Risk factors Coronary artery disease China Validation 



Area under the curve


Body mass index


Coronary artery disease


Coronary angiography


Chinese Multi-Provincial Cohort study




Cardiovascular diseases


Chinese ethics committee of registering clinical trials


Diastolic blood pressure


Diabetes mellitus


Fully conditional specification


Family history


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


Myocardial infarction


Multiple imputation


Obstructive coronary artery disease


Odds ratio


Percutaneous coronary intervention


Predictive value of contrast volume to creatinine clearance ratio


Receiver-operating characteristic


Systolic blood pressure


Total cholesterol


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.

Authors’ Contributions

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

Not applicable.

Conflict of Interest

The authors declare that they have no competing interests.

Supplementary material

12265_2018_9837_MOESM1_ESM.docx (27 kb)
ESM 1 (DOCX 27 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Yong Liu
    • 1
    • 2
  • Qiang Li
    • 2
  • Shiqun Chen
    • 2
    • 3
  • Xia Wang
    • 2
  • Yingling Zhou
    • 1
    • 3
  • Ning Tan
    • 1
  • Jiyan Chen
    • 1
    Email author
  1. 1.Department of Cardiology, Provincial Key Laboratory of Coronary Heart Disease, Guangdong Cardiovascular Institute, Guangdong General HospitalGuangdong Academy of Medical SciencesGuangzhouChina
  2. 2.The George Institute for Global HealthThe University of New South WalesSydneyAustralia
  3. 3.Department of Cardiology, Guangdong General Hospital Zhuhai HospitalZhuhai Golden Bay Center HospitalZhuhaiChina

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