Artikel
Predictive Accuracy of the SCORE Risk Function for Cardiovascular Disease in Austrian Men and Women
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Veröffentlicht: | 14. September 2004 |
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Gliederung
Text
Introduction
In 2003, a new risk scoring system for cardiovascular risk in clinical practice was developed by the SCORE project group, who assembled a pool of datasets from 12 European cohort studies in order to calculate separate risk functions for high- and low risk regions of Europe [Ref. 1]. The aim of this paper is to evaluate the predictive accuracy of the SCORE risk functions in a large prospectively observed population of Austrian men and women.
Methods
Using the different SCORE functions for low risk regions, we calculated the risk of death from all cardiovascular (ICD-9 401-414, 426-443 with the exception of 426.7, 429.0, 430.0, 432.1, 437.3, 437.4 and 437.5, including 798.1 and 798.2) and coronary heart disease (CHD) events (ICD-9 410-414) over a 10 year period for 55,387 participants (23,526 men and 31,861 women) in the Vorarlberg Health Monitoring & Promotion Programme (VHM&PP) [Ref. 2], [Ref. 3]. The predicted risks were then compared with the estimated 95% confidence intervals of the observed events.
Results
There were 637 (1.15%; 95%CI 1.06-1.24) fatal CHD events, 357 (1.52% 95%CI 1.36-1.68) in men and 280 (0.88% 95%CI 0.78-0.99) in women. This compared to 699 events (1.26%) predicted (relative overestimation overall 9.57%, p<0.05), 413 (1.76%) in men and 286 (0.90%) in women (15.79% relative overestimation in men, p<0.05, 2.27% in women).
We further observed a total of 1134 deaths (2.05% 95%CI 1.93-2.17) for all cardiovascular disease (including CHD), 591 (2.51% 95%CI 2.32-2.72) in men and 543 (1.7% 95%CI 1.57-1.85) in women. The SCORE function predicted 1152 (2.08%) events, 609 (2.59%) in men and 543 (1.7%) in women (3.19% relative overestimation in men).
Discussion
The recently developed SCORE risk function for low risk regions proved an appropriate tool for cardiovascular risk estimation in Austria. However, there was a significant degree of overestimation of coronary heart disease mortality in men. Possible reasons for this, including secular trends and other potentially confounding risk factors will be explored, together with a discussion of methodological problems regarding the estimation and between-cohort comparison of cardiovascular risk scores.
References
- 1.
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