Clinical Significance of Framingham Risk Score, Flow-Mediated Dilation and Pulse Wave Velocity in Patients With Stable Angina

BACKGROUND: To evaluate the age-adjusted Framingham risk score (AFRS), flow-mediated dilation (FMD) and brachial-ankle pulse wave velocity (baPWV) for the prediction of the coronary heart disease (CHD) in patients with stable angina. METHODS AND RESULTS: In 138 consecutive patients with stable angina, the interrelationship and predictive power of CHD were compared between the study parameters. In total, 71 patients demonstrated CHD after scheduled coronary angiography. The AFRS showed significant correlation with FMD (r = -0.43, P < 0.01) and baPWV (r = 0.41, P < 0.01). Based on AFRS, FMD, baPWV and other risk factors of CHD, multivariate analysis showed that AFRS and FMD (odds ratio (OR) 20.098, 95% confidence interval (CI) 4.773-84.627, P < 0.01, and OR 0.865, 95%CI 0.752-0.995, P < 0.05, respectively) were independent predictors of CHD. The area under the receiver operating characteristic (ROC) curves for detecting CHD, AFRS, inverse FMD (iFMD) and baPWV were 0.863, 0.726 and 0.694, respectively (all P < 0.01). However, there was no difference of the area under the ROC curves between AFRS alone and combined complex parameters (AFRS plus iFMD, AFRS plus baPWV, and AFRS plus iFMD plus baPWV) for detecting CHD. CONCLUSIONS: AFRS was a better predictor of CHD than either FMD or baPWV in patients with stable angina. This means that conventional risk factors for cardiovascular disease do not affect uniformly for atherosclerosis in coronary and peripheral arteries.