![]() ![]() Therefore, we collected data on all patients of this age group with CAD according to the International Classification of Disease from the hospital database at the Department of Internal Medicine, Saarland University Medical Center, and HELIOS Hospital Wuppertal, Witten/Herdecke University Medical Center, Germany. We conducted the present investigation to better understand the FRS as an eligible prediction system for CAD in very elderly people over 90 years of age. Thus, new questions arise as to whether the FRS could be used to estimate cardiovascular risk for very elderly people over 90 years of age. Present risk prediction with the FRS might operate less effectively in elderly compared to middle-aged persons, and various traditional risk factors have a weak association with CAD risk in the elderly for example, hypercholesterolemia is a strong cardiovascular risk factor in middle-aged individuals, but not in the elderly. The mean age in the FRS was 49 years old and people younger than 30 years and older than 74 years of age were not considered. FRS and other presently common risk estimation scores are designed for people in middle age. Based on data obtained through the FRS calculations, high-risk patients should be treated, according to the guidelines' recommendations, with lipid-lowering medication and aspirin in the primary prevention of CAD. The Framingham Risk Score (FRS) provides an estimation of the probability of an individual developing CAD in 10 years to detect high-risk persons and to take preventive actions. Currently available CAD risk prediction scores are mostly based on multivariable regression analysis deduced from the Framingham Heart Study in which the traditional risk factors for CAD are taken into consideration such as age, cholesterol levels, blood pressure, smoking, and body weight –. Five or 10 risk assessments for CAD have been assumed worldwide according to the recommendations of the guidelines –. To achieve this goal, several risk prediction scores for CAD have been developed in recent years. There are still ongoing efforts and attempts to improve the risk assessment methods for the prediction of CAD. Therefore, several national and international guidelines and recommendations for preventing CAD were previously published after identifying the risk factors for CAD –. The identification of risk factors for CAD is a basic requirement for establishing possible targeted medical therapy for the primary and secondary prevention of CAD. For this reason, the prediction of CAD risk has gained significant attention in the medical science community worldwide. According to data from epidemiological studies, CAD has an increasingly high mortality rate around the world. Numerous studies and international and national clinical practice guidelines have proven that CAD is caused by the manifestation of atherosclerosis in coronary arteries –. All rights reserved.Coronary artery disease (CAD) is the most common heart disease and hides the high risk for the cause for the development of acute myocardial infarction. Once genotyped, the genetic information may be used to calculate an infinite number of PRSs and contribute to personalize medicine providing clinical value for risk stratification, diagnostics and treatment in CAD as well as in other diseases.Ĭopyright © 2022 Wolters Kluwer Health, Inc. Additionally, data suggest possible value of PRSs for aiding decisions in other aspects of diagnostics and treatment in CAD. When implemented in risk stratification models for primary prevention of cardiovascular disease, PRSs provide modest improvements in discrimination (C-index generally increasing 0-4% points) and reclassification, but yield significant clinical benefit as a risk enhancer. In multiple studies, PRSs have proven to be a measure of CAD risk, more powerful than most established risk factors alone, that can be used from early life to stratify individuals into varying trajectories of lifetime risk. Here, we provide an explanation of the genetic basis for PRSs and review recent literature investigating PRSs and the clinical utility for different aspects of CAD.ĬAD-based PRSs are strongly associated with atherosclerosis burden in the coronary arteries and other vascular beds. Recent advances in genetics have facilitated the calculation of polygenic risk scores (PRSs) based on common genetic risk variants of coronary artery disease (CAD). ![]()
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