Concordancia entre escalas para predicción de riesgo cardiovascular en una cohorte de pacientes. Fundación Cardio Infantil, 2015

Abstract

Introduction: The identification of people without established cardiovascular disease with high risk, is an objective in cardiovascular prevention. Multiple scales of cardiovascular risk have been applied, the most widely spread being ATP III (Framingham), SCORE and AHA / ACC 2013. Materials and Methods: Observational cross-sectional cohort study in patients aged 40 to 75 years who attended the FCI Executive Checking Program in 2015; 4783 patients were evaluated, randomized sample size of 861, who underwent the calculation of cardiovascular risk with the scales of ATP III (Framingham), SCORE and AHA / ACC 2013. Results: Of this population 65.7% were men, average age of 49.7 years, finding high risk AHA 2013 of 14.6%, Framingham 2.2% and SCORE 1.1%. Middle risk found SCORE of 26.9%, AHA 2013 of 17.1% and Framingham of 14.4%. For low risk was Framingham 83.3%, SCORE 73% and AHA 2013 68.3%. When concordance for high cardiovascular risk between modified Framingham and SCORE showed a moderate concordance (Kappa: 0.47) and when calculating this index between modified Framingham and AHA 2013 the concordance was weak (Kappa: 0.3497). Conclusion: The risk estimate between the scales of ATP III (Framingham), SCORE and AHA 2013 was not concordant. In this population, their estimates are not interchangeable