The evaluation of cardiovascular risk in young patients with acute myocardial infarction

Objectives: Determination of the sensibility of Framingham cardiovascular score in young patients. Material and Methods: A longitudinal, retrospective study which included 54 patients with acute myocardial infarction, with age between 30 and 40 years old, hospitalized in the Cardiology Department of IBCV “Prof. Dr. George IM Georgescu” from Iasi, between 2007 and 2011. We followed the determination of sensibility and the rate of false-negative results of Framingham Risk Score in this particular age group. Statistical analysis was made by using SPSS version 17, statistical tests were chosen according to the dimension of study group and by the type of data distribution. Results: The study group included 54 patients with acute myocardial infarction, having their age between 30 and 40 years old, with a median of 37 years. 49 patients (90.7%) were men, with a median of 37 years, and 5 patients (9.3%) were women, with a median age of 38 years. The analysis of the used parameters in calculating Framingham Risk Score identified the following data: the median of total cholesterol (CT) was 196 mg/dl, with ranges between 113 and 307 mg/dl; median of HDL-cholesterol was 44 mg/dl, with ranges between 25 and 70 mg/dl; median of the systolic blood pressure was 122 mmHg, with ranges between 100 and 170 mmHg. 7 patients (7%) followed anti-hypertensive treatment and 2 patients (3.7%) had Diabetes Mellitus. The comparative analysis of these parameters by sex had shown significant statistical difference only in total cholesterol (p = 0.46, sig. 2-tailed, 199 mg/dl on men and 160 mg/dl on women). The calculation of Framingham Risk Score had shown the following data: median of percentage's score was 6.7%, with ranges between 1.5% and 18.4%, significantly higher in men (p = 0.0001, Exact sig. 1-tailed, 6.7% on men compared with 2.4% on women). 2 patients (3.7%) had high Framingham Risk Score, 14 patients (25.9%) had moderate Framingham risk Score and 38 patients (70.4%) with low risk. The sensibility of Framingham Risk Score was of 30% and the rate of false negative results was 73%. Discussion and Conclusion: Although the association of classic cardiovascular risk factors has an important role in the pathogenesis of coronary disease, the use of Framingham Risk Score (30%) on a young patient between 30 and 40 years old presents a low sensibility, with an important rate of false negative results (73%). In our group of study the vascular age was significantly higher than the biological one, the vascular age being with 11 years higher than the biological age, the statistical difference being highly significant.