Simple Scoring Scheme for Calculating the Risk of Acute Coronary Events Based on the 10-Year Follow-Up of the Prospective Cardiovascular Münster (PROCAM) Study - PROCAM

Description:

PROCAM was a prospective, longitudinal study of men without a history of coronary artery disease in Europe. The present manuscript used the PROCAM dataset to derive a scoring scheme for prediction of acute coronary event risk.

Hypothesis:

Risk of development of coronary artery disease can be predicted using a simple scoring scheme with the variables of age, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, smoking status, presence of diabetes, family history, and systolic blood pressure.

Study Design

Study Design:

Patients Screened: 20,060
Patients Enrolled: 5,389
Mean Follow Up: 10 years
Mean Patient Age: 35 to 65
Female: 0

Patient Populations:

Men aged 35 to 65 recruited from companies and local government authorities in Europe

Exclusions:

Women; and men with a history of myocardial infarction, stroke, angina, or an ECG with signs of ischemic heart disease

Primary Endpoints:

Occurrence of major coronary events defined as sudden cardiac death or definite fatal or nonfatal myocardial infarction on the basis of ECG and/or cardiac enzyme changes

Secondary Endpoints:

None

Drug/Procedures Used:

Men without a history of coronary artery disease were followed for 10 years for the development of cardiovascular disease. Other manuscripts have used the PROCAM population to investigate the role of diabetes, smoking, hypertension, and hypercholesterolemia in the development of coronary artery disease.

Principal Findings:

A total of 5,389 men from the PROCAM study were analyzed. During 10 years of follow-up, 325 major coronary events occurred. Using Cox proportional hazards modeling, a scoring scheme was developed using age, LDL cholesterol, HDL cholesterol, triglycerides, smoking status, presence of diabetes, family history, and systolic blood pressure as variables. The estimated risk based on the scoring system showed very good agreement with the observed incidence (Hosmer-Lemenshow χ2=6.5, p>0.3).

Interpretation:

Among men without coronary artery disease at baseline, the PROCAM scoring system identified eight baseline characteristics that were associated with subsequent development of acute coronary artery events. The risk score was a simple and accurate method to predict global risk of events.

References:

Assmann G, Cullen P, Schulte H. Simple scoring scheme for calculating the risk of acute coronary events based on the 10-year follow-up of the prospective cardiovascular Munster (PROCAM) study. Circulation 2002;105:310-5.

Clinical Topics: Diabetes and Cardiometabolic Disease, Dyslipidemia, Prevention, Atherosclerotic Disease (CAD/PAD), Homozygous Familial Hypercholesterolemia, Lipid Metabolism, Nonstatins, Hypertension, Smoking

Keywords: Coronary Artery Disease, Myocardial Infarction, Follow-Up Studies, Cholesterol, LDL, Risk Factors, Cholesterol, HDL, Hypercholesterolemia, Triglycerides, Hypertension, Diabetes Mellitus, Smoking


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