RESUMO
BACKGROUND AND OBJECTIVE: Framingham-REGICOR and SCORE (Systematic Coronary Risk Evaluation) are 2 functions charts recommended to estimate the cardiovascular risk stratification in Spain. The aim of the present study was to validate to 10 years the SCORE and REGICOR functions charts in 40 to 65 years old population. PATIENTS AND METHOD: 608 patients (56.7% female) with non evidence of cardiovascular disease were included in the present study. Patients were classified as high risk by REGICOR (> or = 10%) and by SCORE (> or = 5%) functions. RESULTS: The 90.6% of the population (551 subjects) did not experienced any cardiovascular events during the 10 years follow-up. The REGICOR function chart underestimated the coronary risk (4.9% vs 7.9%; p < 0.001), whereas the SCORE overestimated the cardiovascular risk of death (2.1% vs 1.5%; p < 0.001). In the SCORE function, the average risk of patients with events was 6.1%, whereas the average risk of patients without events was 2.0% (p < 0.001) and 7.1% vs 4.8% (p < 0.001) in the REGICOR equation. The SCORE function obtained better validity criteria than REGICOR with a sensibility of 66.7% (95% confidence interval [CI], 66.2-67.2), especificity of 91.7%, (95% CI, 91.2-92.2) positive likelihood ratio of 8 (95% CI, 7.5-8.5), and eficacy of 91.1% (95% CI, 90.6-91.6). These results were observed in both sexes: women -sensibility: 33.3% (95% CI, 32.4-34.2); especificity: 97.4% (95% CI, 96.5-98.3)- and men -sensibility: 83.3% (95% CI, 82.7-83.9); especificity: 84.0% (95% CI, 83.4-84.6). CONCLUSIONS: The SCORE equation obtains better validity criteria than the REGICOR equation both in the total population and in males and females separately. These results make the SCORE function a powerful tool to estimate the cardiovascular risk.
Assuntos
Doenças Cardiovasculares/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Medição de Risco , Fatores de Risco , Sensibilidade e Especificidade , Espanha/epidemiologia , População UrbanaRESUMO
Fundamento y objetivo: Las funciones de Framingham-REGICOR y SCORE (Systematic Coronary Risk Evaluation) se recomiendan para la estratificación del riesgo cardiovascular en nuestro país. El objetivo del presente estudio ha sido validar a 10 años las tablas del SCORE y REGICOR en población de 40-65 años de edad. Pacientes y método: La muestra estaba formada por un total de 608 pacientes (un 56,7% mujeres) sin evidencia de enfermedad cardiovascular. Se consideraron pacientes de riesgo alto aquellos con un riesgo >= 10% en REGICOR y >= 5% en SCORE. Resultados: El 90,6% de la población (551 pacientes) se mantuvo libre de episodios cardiovasculares durante los 10 años de seguimiento. La función de REGICOR subestimó el riesgo coronario (el 4,9 frente al 7,9%; p < 0,001), mientras que el SCORE sobrestimó el riesgo de muerte cardiovascular (un 2,1 frente a un 1,5%; p < 0,001). El riesgo medio de los pacientes que presentaron episodios comparado con el de los que no los sufrieron fue del 6,1 frente al 2,0% (p < 0,001) en las tablas SCORE y del 7,1 frente al 4,8% (p < 0,001) en la función de REGICOR. La función SCORE logró mejores criterios de validez que REGICOR, con una sensibilidad del 66,7% (intervalo de confianza [IC] del 95%, 66,2-67,2), especificidad del 91,7% (IC del 95%, 91,2-92,2), cociente de probabilidad positivo de 8 (IC del 95%, 7,5-8,5) y eficacia del 91,1% (IC del 95%, 90,6-91,6). Estos mejores resultados se observaron tanto en mujeres sensibilidad del 33,3% (IC del 95%, 32,4-34,2); especificidad del 97,4% (IC del 95%, 96,5-98,3) como en varones sensibilidad del 83,3% (IC del 95%, 82,7-83,9); especificidad del 84,0% (IC del 95%, 83,4-84,6). Conclusiones: La ecuación del SCORE obtiene mejores criterios de validez que la tabla del REGICOR tanto en la población total como en varones y en mujeres, lo que justificaría su elección como función de cálculo de riesgo cardiovascular
Background and objetive: Framingham-REGICOR and SCORE (Systematic Coronary Risk Evaluation) are 2 functions charts recommended to estimate the cardiovascular risk stratification in Spain. The aim of the present study was to validate to 10 years the SCORE and REGICOR functions charts in 40 to 65 years old population. Patients and method: 608 patients (56.7% female) with non evidence of cardiovascular disease were included in the present study. Patients were classified as high risk by REGICOR (>= 10%) and by SCORE (>= 5%) functions. Results: The 90.6% of the population (551 subjets) did not experienced any cardiovascular events during the 10 years follow-up. The REGICOR function chart underestimated the coronary risk (4.9% vs 7.9%; p < 0.001), whereas the SCORE overestimated the cardiovascular risk of death (2.1% vs 1.5%; p < 0.001). In the SCORE function, the average risk of patients with events was 6.1%, whereas the average risk of patients without events was 2.0% (p < 0.001) and 7.1% vs 4.8% (p < 0.001) in the REGICOR equation. The SCORE function obtained better validity criteria than REGICOR with a sensibility of 66.7% (95% confidence interval [CI], 66.2-67.2), especificity of 91.7%, (95% CI, 91.2-92.2) positive likelihood ratio of 8 (95% CI, 7.5-8.5), and eficacy of 91.1% (95% CI, 90.6-91.6). These results were observed in both sexes: women sensibility: 33.3% (95% CI, 32.4-34.2); especificity: 97.4% (95% CI, 96.5-98.3) and men sensibility: 83.3% (95% CI, 82.7-83.9); especificity: 84.0% (95% CI, 83.4-84.6). Conclusions: The SCORE equation obtains better validity criteria than the REGICOR equation both in the total population and in males and females separately. These results make the SCORE function a powerful tool to estimate the cardiovascular risk
