Prognostic value of Framingham Cardiovascular Risk Score in hospitalized stroke patients

Abstract

The Framingham Coronary Risk Score (FCRS) is based on several factors, including age, sex, total cholesterol, high-density lipoprotein cholesterol, systolic blood pressure, presence of diabetes, and cigarette smoking. Some of these factors are individually linked with acute stroke outcomes. We explored whether FCRS could predict outcome in patients hospitalized with recent stroke. We collected data on consecutive patients hospitalized for ischemic stroke over a 3-year period. Patients with known coronary artery disease were excluded. Discharge outcomes assessed were neurologic deficit (National Institutes of Health Stroke Scale [NIHSS] score), death or disability (modified Rankin Scale [mRS] score ≥2), and discharge to home directly from the hospital. The independent effect of FCRS on these outcomes was evaluated using multivariate regression analysis. During the study period, 434 patients with ischemic stroke met entry criteria (mean age, 64.5 years; 54% females). Median FCRS score was 8%. After adjusting for confounders, higher FCRS score was associated with an increased likelihood of death or being disabled at discharge (odds ratio [OR]=4.9; 95% confidence interval [CI]=0.98-24.1; P=.05), and a decreased likelihood of being discharged directly to home (OR=0.18; 95% CI=0.04-0.86; P=.032), but not with discharge NIHSS score. Higher FCRS in hospitalized ischemic stroke patients is associated with death or disability at discharge and a lower likelihood of being discharged directly to home. Along with indexing the long-term risk of cardiovascular events, this widely known, easily calculable score provides clinically relevant short-term prognostic information following ischemic stroke.