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Metabolic syndrome & Framingham Risk Score: observations from a coronary angiographic study in Indian patients.
Indian J Med Res. 2013 Feb; 137(2):295-301.IJ

Abstract

BACKGROUND & OBJECTIVES

Metabolic syndrome (MS) is an important determinant of cardiovascular (CV) risk. Framingham Risk Scores (FRS) often underestimate the CV risk in Asians, younger patients and those with MS. Asians often develop coronary artery disease (CAD) at a younger age and also have a high prevalence of MS. Only limited data are available on the relationship between MS and FRS in such patients and the present study was undertaken to report on this aspect in an Indian patient population with angiographically documented CAD.

METHODS

Two hundred patients undergoing coronary angiography during a three months study period were included. Diagnosis of MS was based on modified south Asian guidelines.

RESULTS

Of the 200 patients (age 56.5 ± 8.6 yr) undergoing coronary angiography, MS was diagnosed in 77 per cent n=154; abdominal obesity, low HDL and hypertension were the commonest of the diagnostic criteria of MS, being present in >70 per cent cases. Patients with MS had significantly higher mean FRS than those without MS (15.1 vs 8.65, P<0.0001). Most patients with MS (74%, n=148) had an intermediate to high 10-year CV risk (>10%) as estimated by FRS. The proportion of patients with MS progressively increased in those with low, intermediate and high FRS (61, 87 and 92%, respectively). Though the prevalence of MS was uniformly similar (74-84%) in all age groups (<45, 45-55, 55-65 and > 65 yr, respectively), amongst those <45 yr, none of the patients could be categorized as having high CV risk as estimated by FRS despite having angiographic CAD, highlighting the limitation of age dependence of FRS.

INTERPRETATION & CONCLUSIONS

MS is common in Indian patients with angiographically documented CAD; most patients with MS have 10-year risk of >10 per cent as estimated by FRS. Though MS is uniformly prevalent across all age groups, using the FRS may underestimate the CV risk in Indian patients despite documented CAD. These findings have significant implications for Asian patients with CAD in whom onset of CAD is often at a younger age than their Western counterparts. There should be continued health care emphasis on detection of MS and intensification of targeted preventive strategies.

Authors+Show Affiliations

Department of Cardiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23563372

Citation

Khanna, Roopali, et al. "Metabolic Syndrome & Framingham Risk Score: Observations From a Coronary Angiographic Study in Indian Patients." The Indian Journal of Medical Research, vol. 137, no. 2, 2013, pp. 295-301.
Khanna R, Kapoor A, Kumar S, et al. Metabolic syndrome & Framingham Risk Score: observations from a coronary angiographic study in Indian patients. Indian J Med Res. 2013;137(2):295-301.
Khanna, R., Kapoor, A., Kumar, S., Tewari, S., Garg, N., & Goel, P. K. (2013). Metabolic syndrome & Framingham Risk Score: observations from a coronary angiographic study in Indian patients. The Indian Journal of Medical Research, 137(2), 295-301.
Khanna R, et al. Metabolic Syndrome & Framingham Risk Score: Observations From a Coronary Angiographic Study in Indian Patients. Indian J Med Res. 2013;137(2):295-301. PubMed PMID: 23563372.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Metabolic syndrome & Framingham Risk Score: observations from a coronary angiographic study in Indian patients. AU - Khanna,Roopali, AU - Kapoor,Aditya, AU - Kumar,Sudeep, AU - Tewari,Satyendra, AU - Garg,Naveen, AU - Goel,Pravin K, PY - 2013/4/9/entrez PY - 2013/4/9/pubmed PY - 2014/1/1/medline SP - 295 EP - 301 JF - The Indian journal of medical research JO - Indian J Med Res VL - 137 IS - 2 N2 - BACKGROUND & OBJECTIVES: Metabolic syndrome (MS) is an important determinant of cardiovascular (CV) risk. Framingham Risk Scores (FRS) often underestimate the CV risk in Asians, younger patients and those with MS. Asians often develop coronary artery disease (CAD) at a younger age and also have a high prevalence of MS. Only limited data are available on the relationship between MS and FRS in such patients and the present study was undertaken to report on this aspect in an Indian patient population with angiographically documented CAD. METHODS: Two hundred patients undergoing coronary angiography during a three months study period were included. Diagnosis of MS was based on modified south Asian guidelines. RESULTS: Of the 200 patients (age 56.5 ± 8.6 yr) undergoing coronary angiography, MS was diagnosed in 77 per cent n=154; abdominal obesity, low HDL and hypertension were the commonest of the diagnostic criteria of MS, being present in >70 per cent cases. Patients with MS had significantly higher mean FRS than those without MS (15.1 vs 8.65, P<0.0001). Most patients with MS (74%, n=148) had an intermediate to high 10-year CV risk (>10%) as estimated by FRS. The proportion of patients with MS progressively increased in those with low, intermediate and high FRS (61, 87 and 92%, respectively). Though the prevalence of MS was uniformly similar (74-84%) in all age groups (<45, 45-55, 55-65 and > 65 yr, respectively), amongst those <45 yr, none of the patients could be categorized as having high CV risk as estimated by FRS despite having angiographic CAD, highlighting the limitation of age dependence of FRS. INTERPRETATION & CONCLUSIONS: MS is common in Indian patients with angiographically documented CAD; most patients with MS have 10-year risk of >10 per cent as estimated by FRS. Though MS is uniformly prevalent across all age groups, using the FRS may underestimate the CV risk in Indian patients despite documented CAD. These findings have significant implications for Asian patients with CAD in whom onset of CAD is often at a younger age than their Western counterparts. There should be continued health care emphasis on detection of MS and intensification of targeted preventive strategies. SN - 0971-5916 UR - https://www.unboundmedicine.com/medline/citation/23563372/Metabolic_syndrome_&_Framingham_Risk_Score:_observations_from_a_coronary_angiographic_study_in_Indian_patients_ L2 - http://www.ijmr.org.in/article.asp?issn=0971-5916;year=2013;volume=137;issue=2;spage=295;epage=301;aulast=Khanna DB - PRIME DP - Unbound Medicine ER -