| Title: | 3-POINT CORRECTION FACTOR IMPROVES ACCURACY OF FRAMINGHAM RISK SCORE IN BREAST CANCER SURVIVORS |
| Journal: | Canadian Journal of Cardiology |
| Published: | 8 Apr 2026 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/41962842/ |
| DOI: | https://doi.org/10.1016/j.cjca.2026.03.051 |
Publication 18062
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Abstract
BACKGROUND: After surviving breast cancer (BC), women are at 2-6-fold greater risk of death due to cardiovascular disease (CVD) than women without BC. The Framingham Risk Score (FRS) is an estimate of an individual's risk of CVD but does not account for cancer history.</p>
OBJECTIVES: To determine whether BC history modified FRS prediction of CVD events and if a derived correction factor would improve its accuracy.</p>
METHODS: Females from the UK Biobank prospective cohort with and without (controls) a history of BC were included and those who experienced a CVD event prior to study enrollment were excluded. The primary outcome was a composite of CVD events derived from primary care/hospital visits and death with CVD ICD-10 codes during 10 years of follow-up.</p>
RESULTS: 4,808 BC survivors and 171,427 controls were included. BC survivors had >50% higher risk of CVD events (adjusted hazard ratio (aHR)=1.51, 1.39-1.65). FRS (%) was a significant predictor of CVD in both groups with attenuation in BC survivors (aHR 1.03, 1.02-1.05 vs aHR 1.06, 1.06-1.07). A greater proportion of BC experienced CVD events within the low (aHR: 1.65, 1.44-1.99) and intermediate (aHR: 1.36, 1.19-1.54) FRS categories. A 3-point derived correction factor for BC history added to the FRS sum increased the predictive accuracy for BC survivors (observed/expected improved from 1.41 to 0.93).</p>
CONCLUSIONS: FRS significantly underestimated CVD events among BC suvivors, but +3-point correction factor substantially improved predictive ability. This is a simple strategy that can be used by clinicians to improve CVD risk management among BC survivors.</p>
7 Authors
- Julia N Rickard
- Rebecca A G Christensen
- Jennifer S Williams
- Husam Abdel-Qadir
- Stephanie D Small
- Daniel Santa Mina
- Amy A Kirkham
1 Application
| Application ID | Title |
|---|---|
| 83076 | Cardiometabolic and lifestyle determinants of cardiovascular disease risk in breast cancer survivors |
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