The study to explore the association of Coronary calcium score and myocardial ischemia score with Framingham risk score －in adults for health examination

• Main Authors: Ya-Chien Chen, 陳雅倩
• Other Authors: 林正介
• Format: Others
• Language: zh-TW
• Published: 2011
• Online Access: http://ndltd.ncl.edu.tw/handle/56567562268348860645

碩士 === 中國醫藥大學 === 醫務管理學系碩士在職專班 === 99 === Research Background and motivation The Executive Yuan Department of Health announced the statistics of major causes of death in Taiwan for 2010. Malignant tumors was the top one leading cause of death, accounting for 27.3% of all deaths, followed by heart disease and cerebrovascular disease, accounting for 11.1% and 7.5% of deaths, respectively. In the past, coronary artery disease afflicted mainly the elderly, but in recent years there has been a trend of the disease presenting in a younger population, which may be attributed to excessive dietary fat intake and lack of exercise. With increasing emphasis on preventive medicine, the risk of heart disease in health-checkup customer is predicted through analysis of Framingham risk score. Then the risk of coronary artery disease is determined through examination with advanced technology for early detection and early treatment of disease. Through the health management interventions, the goal of prevention over treatment can be achieved. Research Objectives There are three research objectives and they are as follows: 1.To assess the relationship between coronary calcium score and the Framingham risk score. 2.To assess the relationship between myocardial ischemic index and the Framingham risk score. 3.To assess the relationship among coronary calcium score, myocardial ischemic index and the Framingham risk score. Research Methods This study retrospectively enrolled 68 examinees who underwent MDCT for health-checkup and concurrent myocardial perfusion imaging from January 2008 to December 2009 in a medical center of the central Taiwan. Examinees with the Framingham risk score 32%, the 1st tertile, were categorized as high risk group whereas those with the Framingham risk score <2% were categorized as low risk group. The statistical analysis consisted of Wilcoxon’s rank sums test, Chi-square test, Fisher’s exact test, and logistic regression, which were used to analyze the relationship among coronary calcium score, myocardial ischemic index and the Framingham risk score. All analyses were performed with the SAS statistical package for Windows (Version 9.2, SAS, Cary, NC). Results A total of 49 participants were categorized as high risk group and they were at older group, and had a higher level of systolic blood pressure, a lower level of high density lipoprotein and a higher level of calcium score. Individuals with coronary calcium score3117 were associated with higher likelihood of Framingham risk score32% (odds ratio: 3.42, 95% CI: 1.11-10.54). There was no significant association between myocardial ischemic index and Framingham risk score. Given coronary calcium score3117, there was an increasing trend in the odds ratio of Framingham risk score32% as the levels of myocardial perfusion index increased. Conclusion With an emphasis on preventive medicine in the twenty-first century, modern medicine makes use of developments in technology and information to facilitate early detection of disease through the use of precision instruments. The goal of early treatment will be achieved by adopting behavioral modification and interventions such as healthy diets, regular exercise, and good control of blood pressure, blood sugar and blood lipids to high-risk examinees for reduction of cardiovascular disease risk.