Abstract
Motivation: In Colombia, different models of cardiovascular risk assessment are currently being
used. The motivation of this study is to analyse the concordance between the ACC/AHA 2013
equation, SCORE and adjusted Framingham, as well as the impact of using one or another in the
amount of patients classified as high risk and the amount of patients requiring pharmacological
management.
Methods: 800 patients between 40 and 74 years old were assessed, from the primary prevention clinic of the Hospital Militar Central in Bogotá (Colombia), who were free of cardiovascular
events. 10-year risk for atherosclerotic vascular disease was estimated according to the equations proposed by ACC/AHA 2013 guides, the risk of cardiovascular death according to the SCORE
function of the European guide and the coronary risk according to the adjusted Framingham
function recommended by the Colombian guide. The indication of pharmacological management
was considered with an ACC/AHA or adjusted Framingham risk of > 7.5%. A >20% Framingham or
a >5% SCORE risk were considered high risk.
Results: According to Framingham there was a 5.9% of high-risk patients, according to SCORE
equations for low-risk countries an 18.7% and according to SCORE equations for high-risk countries, a 31.2%. The Kappa coefficient showed a low concordance between adjusted Framingham
and each of the SCORE equations (0.28 and 0.22 respectively). According to the ACC/AHA guide
recommendations, hypolipidemic treatment would be indicated in 40.8% of patients, versus a
50.6% following the Colombian guide indications (adjusted Framingham). Kappa coefficient was
0.5735.
Conclusions: Nowadays there is a poor agreement between the different cardiovascular risk
assessment scales used in Colombia, thus generating uncertainty when it comes to making
therapeutic choices. Data from this study show the need to validate the validate the SCORE
and ACC/AHA models in Colombia and Latin America
used. The motivation of this study is to analyse the concordance between the ACC/AHA 2013
equation, SCORE and adjusted Framingham, as well as the impact of using one or another in the
amount of patients classified as high risk and the amount of patients requiring pharmacological
management.
Methods: 800 patients between 40 and 74 years old were assessed, from the primary prevention clinic of the Hospital Militar Central in Bogotá (Colombia), who were free of cardiovascular
events. 10-year risk for atherosclerotic vascular disease was estimated according to the equations proposed by ACC/AHA 2013 guides, the risk of cardiovascular death according to the SCORE
function of the European guide and the coronary risk according to the adjusted Framingham
function recommended by the Colombian guide. The indication of pharmacological management
was considered with an ACC/AHA or adjusted Framingham risk of > 7.5%. A >20% Framingham or
a >5% SCORE risk were considered high risk.
Results: According to Framingham there was a 5.9% of high-risk patients, according to SCORE
equations for low-risk countries an 18.7% and according to SCORE equations for high-risk countries, a 31.2%. The Kappa coefficient showed a low concordance between adjusted Framingham
and each of the SCORE equations (0.28 and 0.22 respectively). According to the ACC/AHA guide
recommendations, hypolipidemic treatment would be indicated in 40.8% of patients, versus a
50.6% following the Colombian guide indications (adjusted Framingham). Kappa coefficient was
0.5735.
Conclusions: Nowadays there is a poor agreement between the different cardiovascular risk
assessment scales used in Colombia, thus generating uncertainty when it comes to making
therapeutic choices. Data from this study show the need to validate the validate the SCORE
and ACC/AHA models in Colombia and Latin America
| Translated title of the contribution | Concordance between the SCORE and Framingham models and ACC/AHA equations as cardiovascular risk indicators |
|---|---|
| Original language | Spanish |
| Pages (from-to) | 110-116 |
| Number of pages | 7 |
| Journal | Revista Colombiana de Cardiologia |
| Volume | 24 |
| Issue number | 2 |
| DOIs | |
| State | Published - 01 Mar 2017 |
Keywords
- Epidemiology
- Primary prevention
- Cardiovascular diseases
- Risk of coronary heart disease
- Concordance studies