Estimates of absolute cardiovascular risk in the Czech Republic
Authors:
J. Reissigová 1; J. Zvárová 1,2
Authors‘ workplace:
Evropské centrum pro medicínskou informatiku, statistiku a epidemiologii
Ředitelka: prof. RNDr. Jana Zvárová, DrSc.
; Oddělení medicínské informatiky, Ústav informatiky AV ČR v. v. i., Praha
1; Univerzita Karlova v Praze, 1. LF a VFN
Ústav hygieny a epidemiologie
Přednosta: prof. MUDr. Vladimír Bencko, DrSc.
2
Published in:
Prakt. Lék. 2008; 88(5): 288-292
Category:
Of different specialties
Overview
Aim:
The aim was to validate estimates of absolute ten-year cardiovascular risk in men from the Czech Republic:
a) the risk of coronary heart diseases (CHD) estimated by the Framingham risk function (1998), and
b) the risk of fatal cardiovascular disease estimated by the SCORE nomogram (2005).
Material and Methods:
The estimates were validated within the longitudinal primary prevention study of atherosclerotic risk factors (STULONG). Calibration and discrimination accuracies of the estimates were evaluated by the Hosmer-Lemeshow test and ROC curve, respectively.
Results:
The 10-year risk of CHD was estimated according to the Framingham risk function (1998) for each man (n=646). Men were categorized into five groups defined by quintiles of the estimated risk. The estimated ten-year risk was lower than that observed in all five groups (p=0.013). Discrimination accuracy of the Framingham risk function was 63.8 %, 95% CI (58.4 %, 69.1 %). The SCORE nomogram was validated in 1025 men. The largest difference between the estimated and observed risk was in the groups at the highest estimated risk. Totally, no significant difference between the estimated and observed risk was found at 5% significance level (p=0.068). Discrimination accuracy of the SCORE nomogram was 75.0 %, 95% CI (66.4 %, 83.6 %).
Conclusion:
The Framingham risk function (1998) significantly underestimated the risk of CHD in men from the study STULONG. The SCORE nomogram (2005) estimated the risk of fatal cardiovascular risk better - excluding men at high-risk. Discrimination accuracy of the SCORE nomogram (2005) was somewhat better than that of the Framingham risk function (1998).
Key words:
Framingham heart study, SCORE study, estimate of cardiovascular risk, validation study.
Sources
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General Practitioner
2008 Issue 5
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