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Universal estimation of cardiovascular risk in multi-risk constellations - a “relativity theory” for global risk calculation

Joerg Piper

Abstract


According to various published studies, at least 26 cardiovascular risk factors can contribute to the individual cardiovascular risk. For all of these risk factors quantitative risk multipliers are known which can be systematically derived from various epidemiological findings.

On the other hand, only a few risk factors are considered by the risk scores established (FRAMINGHAM, PROCAM, ESC and HEART score, for instance). Thus, a relevant proportion of patients affected with myocardial infarction or other cardiovascular events do not belong to a high risk group according to these scores.

Thus, alternative tools for universal risk calculation are desirable to improve the significance and sensitivity of such estimations.

Based on “traditional“ risk factors considered by the scores mentioned, mathematical analyses were carried out to describe coincidences of various risk factors with regard to the resulting total risk.  Their quantitative synergism and relativity can be mathematically described by a specific hyperbolic tangent function derived from the PROCAM score.

By other formulas PROCAM risk calculated in this way can be transformed into corresponding FRAMINGHAM and ESC risk which are targeted at other critical end points.

We consider that the special interaction of risk factors described in our mathematical models can be regarded as a general law of nature so that our formulas could be used for universal risk estimations in all risk constellations imaginable, even when multiple risk factors are coincident.

Keywords


Risk factors, interaction, estimation, calculation, score, Framingham, PROCAM, ESC, mathematical models, multi-risk constellations, cardiovascular event, myocardial infarction, cardiovascular death

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References


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DOI: http://dx.doi.org/10.18103/mra.v3i3.475

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