Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Place of cardiovascular risk prediction models in South Asians; Agreement between Framingham risk score and WHO/ISH risk charts(Wiley Publishing, 2021) Mettananda, K.C.D.; Gunasekara, N.; Thampoe, R.; Madurangi, S.; Pathmeswaran, A.INTRODUCTION AND OBJECTIVES: There are no cardiovascular risk prediction models developed in South Asian cohorts. Therefore, different risk models not validated in South Asians are being used. We aimed to compare cardiovascular risk predictions of Framingham risk score (FRS) and World Health Organization/International Society of Hypertension (WHO/ISH) charts for agreement in a sample of South Asians. METHODS: Ten-year cardiovascular risk predictions of patients without previous cardiovascular diseases attending a non-communicable disease clinic were calculated using FRS (with BMI and with cholesterol) and WHO/ISH charts (with and without cholesterol). Patients were categorised into low (<20%) and high (≥20%) cardiovascular risk groups on risk predictions. Agreement in risk categorisation with different prediction models was compared using Cohen's kappa coefficient (κ). RESULTS: One hundred sixty-nine patients (females 130 (81.1%)) mean age 65 ± 6.9 years were studied. Of the participants, 80 (47.3%), 62 (36.7%), 18 (10.7%), 16 (9.5%), were predicted high risk by FRS BMI-based, FRS cholesterol-based, WHO/ISH without-cholesterol and WHO/ISH with-cholesterol models, respectively. Agreement between the two FRS models (κ = 0.736, P < .0001) and the two WHO/ISH models (κ = 0.804, P < .0001) in stratifying patients into high and low-risk groups, was "good." However, the agreements between FRS BMI-based and WHO/ISH without-cholesterol models (κ = 0.234, P < .0001) and FRS cholesterol-based and WHO/ISH with-cholesterol models (κ = 0.306, P < .0001) were only "fair." CONCLUSION: Cardiovascular risk predictions of FRS were higher than WHO/ISH charts and the agreement in risk stratification was not satisfactory in Sri Lankans. Therefore, different cardiovascular risk prediction models should not be used interchangeably in the follow-up of South Asians.Item 30-year cardiovascular risk prediction of medical undergraduates of university of Kelaniya, Sri Lanka(Sri Lanka College of Internal Medicine, 2019) Mettananda, K.C.D.; Gunarathna, M.R.T.A.; Gunasekara, M.D.S.D.; Gunasekara, P.; Gunasekara, T.N.A.S.; Gunasekara, W.S.M.T.M.; Thampoe, R.S.BACKGROUND: Medical students could be at high risk of cardiovascular diseases (CVDs) due to lack of exercises, increased mental stresses, unhealthy dietary practices. However, there are no reported data on this from Sri Lanka. OBJECTIVE: We aimed to predict 30-year CVD-risk of medical students of University of Kelaniya. METHODS: A cross-sectional study was conducted among medical students of Faculty of Medicine, University of Kelaniya during November 2018. 20 students from each batch were randomly selected. Data were collected using an interviewer administered questionnaire. 30-year risk of General-CVDs were calculated using Framingham 30- year CVD-risk calculator using sex, age, systolic blood pressure, use of antihypertensive medications, smoking, presence of diabetes mellitus and body mass index(BMI). Data was analysed using SPSSversion-22. RESULTS: 100 students (female 59(59%)) aged 21-29 years (mean 24.8 ± 1.8 years) were studied. Cardiovascular risk factor prevalences were; hypertension 1(I%), hyperlipidaemia 2(2%), diabetes mellitus I (I %), smoking 3(3%), overweight 37(37%) and obesity 2(2%). Mean 30-year hard-CVD risk was 2.13% (SD±l .63), mean 30-year general-CVD risk was 4.58% (SD±2.88). Majority (93%) were low-risk, and 7% were at moderate-risk and none were categorised high-risk. Of the moderate risk participants, 5(28.6%) were male (p=0.11), 6(87.7%) (p=0.043) were overweight but none were smokers nor had diabetes mellitus, hypertension or hyperlipidaemia. CONCLUSION: Majority of current medical students of University of Kelaniya e at low risk of future CVD events. The commonest risk factor seen among moderate risk students was being overweight. This emphasize the importance of adhering to healthy lifestyle.