Multiple sclerosis and related disorders · 2026
The Framingham score is a marker of early disability progression in multiple sclerosis.
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Barros Felipe C D, Menezes Felipe T L, Bessa Natasha P A, Lessa Vanessa C C, Lopes Alexandre B, Alencar Jessica M D, Bichuetti Denis B, Souza Nilton A, Silva Gisele S, Oliveira Enedina M L
Аннотация
BACKGROUND: Multiple sclerosis (MS) may have its prognosis affected by several cardiovascular risk factors. The Framingham Score is a systematic way to measure the biological interactions of cardiovascular risk factors and has been related to MS clinical outcomes.
OBJECTIVE: assess whether the Framingham score is associated with an increased risk of MS disability, as stated by the risk of reaching an Expanded Disability Status Scale (EDSS) score of 6 during follow-up in multiethnic population in a middle-income country.
METHODS: This retrospective study evaluates the relationship between the Framingham Score and the last visit EDSS score, calculated using a logistic regression model, with further adjustments for confounding risk factors and a decision tree algorithm analysis. Data was collected from a tertiary multiple sclerosis (MS) center for patients admitted between 1994 and 2019.
RESULTS: Among 2036 medical records, we included 284 patients for final analysis. Patients who reached an EDSS of 6 or more had a mean Framingham score of 9.9 versus 5.8 among those who did not reach such EDSS. There was a positive Spearman correlation between the Framingham general cardiovascular risk score and the last-visit EDSS (rₛ = 0.414, p < 0.001). In logistic regression models using EDSS ≥ 6 as the outcome, higher Framingham scores were associated with greater odds of disability in unadjusted analyses, but this association was attenuated after adjustment for age. Among patients with baseline EDSS 0-2.5, the Framingham score significantly predicted a higher final EDSS. In this group, 25.3% of those with a score >1.91 reached EDSS ≥ 6, versus 3.9% with a score ≤1.91.
DISCUSSION: Our study reported an association between cardiovascular risk, as measured by the Framingham score, and disability in MS, measured by the last visit EDSS score, in a middle-income MS cohort with access to DMD. Such correlation is stronger and statistically significant among patients with an EDSS between 0 and 2.5. There is an association between the Framingham score and a higher final EDSS in patients with multiple sclerosis when the cardiovascular risk factors are present in the early course of the disease.
OBJECTIVE: assess whether the Framingham score is associated with an increased risk of MS disability, as stated by the risk of reaching an Expanded Disability Status Scale (EDSS) score of 6 during follow-up in multiethnic population in a middle-income country.
METHODS: This retrospective study evaluates the relationship between the Framingham Score and the last visit EDSS score, calculated using a logistic regression model, with further adjustments for confounding risk factors and a decision tree algorithm analysis. Data was collected from a tertiary multiple sclerosis (MS) center for patients admitted between 1994 and 2019.
RESULTS: Among 2036 medical records, we included 284 patients for final analysis. Patients who reached an EDSS of 6 or more had a mean Framingham score of 9.9 versus 5.8 among those who did not reach such EDSS. There was a positive Spearman correlation between the Framingham general cardiovascular risk score and the last-visit EDSS (rₛ = 0.414, p < 0.001). In logistic regression models using EDSS ≥ 6 as the outcome, higher Framingham scores were associated with greater odds of disability in unadjusted analyses, but this association was attenuated after adjustment for age. Among patients with baseline EDSS 0-2.5, the Framingham score significantly predicted a higher final EDSS. In this group, 25.3% of those with a score >1.91 reached EDSS ≥ 6, versus 3.9% with a score ≤1.91.
DISCUSSION: Our study reported an association between cardiovascular risk, as measured by the Framingham score, and disability in MS, measured by the last visit EDSS score, in a middle-income MS cohort with access to DMD. Such correlation is stronger and statistically significant among patients with an EDSS between 0 and 2.5. There is an association between the Framingham score and a higher final EDSS in patients with multiple sclerosis when the cardiovascular risk factors are present in the early course of the disease.