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Utility of Framingham Coronary Heart Disease Risk Score for predicting cardiac risk after stroke

Amytis Towfighi1, Daniela Markovic, Bruce Ovbiagele

  • 1Department of Neurology, University of Southern California, Los Angeles, CA, USA. towfighi@usc.edu

Stroke
|September 6, 2012
PubMed

Insights

The Framingham Coronary Heart Disease Risk Score (FCRS) effectively identifies stroke patients at high risk for myocardial infarction (MI) and vascular death. This score aids in stratifying stroke patients for targeted coronary heart disease management.

Area of Science:

  • Cardiology
  • Neurology
  • Public Health

Background:

  • Coronary heart disease (CHD) is a leading cause of mortality post-stroke.
  • Effective risk stratification is needed for stroke patients without known CHD.
  • Identifying high-risk individuals can guide CHD-specific management.

Purpose of the Study:

  • To evaluate the Framingham Coronary Heart Disease Risk Score (FCRS) as a prognostic tool.
  • To assess FCRS utility in predicting cardiac events in stroke patients without prior CHD.
  • To determine if FCRS can identify stroke patients benefiting from enhanced CHD care.

Main Methods:

  • Post hoc analysis of 3509 ischemic stroke patients (≥35 years) from a 2-year trial.
  • Categorization based on known CHD, high FCRS (≥20%), and low/intermediate FCRS (<20%).
  • Multivariate analysis of FCRS predicting myocardial infarction (MI), vascular death, and recurrent stroke.

Main Results:

  • High FCRS (≥20%) significantly predicted higher risk of MI (aHR 3.70) and MI or vascular death (aHR 2.21) compared to low/intermediate FCRS.
  • MI rates at 2 years were 6.34% (known CHD), 4.65% (high FCRS), and 1.44% (low/intermediate FCRS).
  • High FCRS did not predict recurrent stroke outcomes.

Conclusions:

  • In stroke patients without known CHD, elevated FCRS identifies individuals at increased risk of MI and vascular death.
  • FCRS serves as a simple, valuable tool for identifying stroke survivors who may benefit from intensified CHD management.
  • The score's utility lies in proactive cardiac risk management following ischemic stroke.
Abstract

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