Predictive validity of the risk SCORE model in a Mediterranean population with dyslipidemia
| Autor: | Vicente Bertomeu-González, Domingo Orozco-Beltrán, Jesús Bleda-Cano, Jorge Navarro-Pérez, Jose A. Quesada, Vicente Gil Guillén, Concepción Carratalá-Munuera, Carlos Brotons, Cristina Soriano Maldonado, Sara Carrascosa-Gonzalvo, Adriana Lopez-Pineda |
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| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Predictive validity Adult Male medicine.medical_specialty Time Factors Population Hypercholesterolemia 030204 cardiovascular system & hematology Risk Assessment 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Risk Factors Internal medicine Diabetes mellitus SCORE medicine Humans Prospective Studies Registries education Aged education.field_of_study Framingham Risk Score business.industry Reproducibility of Results Middle Aged medicine.disease Cardiovascular disease Cardiovascular risk Prognosis 030104 developmental biology Cardiovascular Diseases Spain Cohort Disease Progression Female Metabolic syndrome Cardiology and Cardiovascular Medicine business Dyslipidemia Kidney disease |
| Zdroj: | Atherosclerosis r-FISABIO: Repositorio Institucional de Producción Científica Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO) r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante instname r-FISABIO. Repositorio Institucional de Producción Científica ATHEROSCLEROSIS r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA |
| ISSN: | 1879-1484 0021-9150 |
| Popis: | Background and aims: Cholesterol treatment for the primary prevention of cardiovascular disease is based on cardiovascular risk, as assessed by the SCORE (Systematic COronary Risk Evaluation) scale. This study aimed to assess the predictive value and clinical utility of the SCORE scale for preventing cardiovascular events and all-cause mortality in people with dyslipidemia and no lipid-lowering treatment. Methods: Patients with dyslipidemia and no lipid-lowering treatment were included from the ESCARVAL-RISK cohort. Cardiovascular risk was calculated by means of the SCORE scale. All deaths and cardiovascular events were recorded for up to five years of follow-up. We calculated sensitivity, specificity and other predictive values for different cut-off points and assessed the effect of different risk factors on the diagnostic accuracy of the SCORE charts. Results: In the final cohort of 18,853 patients, there were 1565 cardiovascular events and 268 deaths. The risk value recommended to initiate pharmacological treatment (5%) presented a specificity of 86% for death and 90% for cardiovascular events, and a sensitivity of 53% for death and 32% for cardiovascular events. In addition, the scale classified as low risk 62.8% of the patients who suffered a cardiovascular event and 46.6% of those who died. Antithrombotic treatment, diabetes, hypertension, heart failure, peripheral artery disease and chronic kidney disease were associated with a reduction in the predictive capability of the SCORE scale, whereas metabolic syndrome was related to better risk prediction. Conclusions: The predictive capability of the SCORE scale for cardiovascular disease and total mortality in patients with dyslipidemia is limited. |
| Databáze: | OpenAIRE |
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