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Rev. esp. salud pública ; 79(4): 453-464, jul.-ago. 2005. tab, graf
Artigo em Es | IBECS | ID: ibc-045382

RESUMO

Fundamento: No se dispone de estudios que hayan comparadoSCORE, REGICOR y Framingham. El objetivo de este trabajo esestudiar cómo clasifican el riesgo cardiovascular las funcionesREGICOR y SCORE, su correlación y concordancia respecto a Framingham(1998) y si presentan diferencias respecto a los factores deriesgo cardiovascular en los casos de riesgo alto.Métodos: Estudio descriptivo transversal realizado en atención primaria.Se incluyó a 851 personas entre 35-74 años, libres de enfermedadescardiovasculares y seleccionadas por muestreo aleatorio simple.Se estudió la proporción de pacientes de riesgo alto con Framingham(³20% a 10 años), SCORE (³5% a 10 años) y REGICOR con puntos decorte ³20%, ³15%, ³10% y ³5% a 10 años, ya que con REGICOR³20% apenas hay casos con riesgo alto. Se comparó la correlación (r dePearson) y concordancia (coeficiente Kappa) de las personas de riesgoalto de REGICOR y SCORE respecto a Framingham.Resultados: Presentaron riesgo alto 23,3% con Framingham,15,2% con SCORE y un 1,4%, 5,8%, 17,6% y 57,0% con REGICORcon los puntos de corte descritos, respectivamente. REGICOR tuvouna correlación de 0,99 y SCORE de 0,78. REGICOR ³10% tuvomejor concordancia (Kappa 0,83) que SCORE (Kappa 0,61). Alcomparar los factores de riesgo cardiovascular de los casos con riesgoalto (³20% Framingham, ³5% SCORE y ³10% REGICOR), elsegundo presentó mayor prevalencia de diabetes y menor de hipercolesterolemia(p<0,05).Conclusiones: REGICOR presentó una buena correlación conFramingham. Con el punto de corte ³10% clasifica como riesgo altoa un número de personas similar a SCORE e inferior a Framingham.El modelo SCORE trataría con hipolipemiantes a un número parecidode pacientes que el modelo REGICOR ³10%, pero con menorevidencia de efectividad del tratamiento


Background: No studies have been published to date comparingSCORE, REGICOR and Framingham models. This study isaimed at analyzing how the REGICOR and SCORE functions classifycardiovascular risk, their correlation and concordance withFramingham (1998) and whether any differences exist among themwith regard to the cardiovascular risk factors in high-risk groups.Methods: Descriptive cross-sectional study conducted in primarycare. A total of 851 individuals within the 35-74 age range, freeof cardiovascular diseases and selected by simple random samplingwere included. A study was made of the percentage of high-riskpatients with Framingham (³20% ten-year risk), SCORE (³5% tenyearrisk) and REGICOR with cutoff points ³20%, ³15%, ³10% and³5% at 10 years, given that with REGICOR ³20% there are hardlyany high-risk cases. A comparison was drawn between the correlation(Pearson´s r) and concordance (Kappa index) of the REGICORand SCORE high-risk individuals as compared to Framingham.Results: The high-risk percentages respectively found were:23.3% with Framingham; 15.2%; with SCORE; and 1.4%, 5.8%,17.6% and 57.0% with REGICOR with the cutoff points described.REGICOR has a 0.99 correlation, SCORE a 0.78 correlation. REGICOR³10% showed a better concordance (Kappa 0.83) than SCORE(Kappa 0.61). On comparing the cardiovascular risk factors of thehigh-risk cases (³20% Framingham, ³5% SCORE and ³10% REGICOR),SCORE showed higher prevalence of diabetes and a lowerprevalence of hypercholesterolemia (p<0.05).Conclusions: REGICOR showed a good correlation with Framingham.With the ³10% cutoff point, it classifies a number of individualsas high-risk similar to SCORE and fewer than Framingham.The SCORE model would treat a number of patients similar to theREGICOR ³10% model with hypolipemiant drugs, however showinglesser evidence of effectiveness of the treatment


Assuntos
Masculino , Feminino , Adulto , Idoso , Pessoa de Meia-Idade , Humanos , Doenças Cardiovasculares/epidemiologia , Medição de Risco/métodos , Estudos Transversais , Centros Comunitários de Saúde , Espanha
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