[西班牙巴塞罗那一家医疗中心用于计算无心血管疾病个体心血管风险的SCORE模型与REGICOR模型的比较]

[Comparison of the SCORE and REGICOR models for calculating cardiovascular risk in cardiovascular disease-free individuals at a healthcare center in Barcelona, Spain].

作者信息

Baena Díez José Miguel, del Val Garcia José Luis, Héctor Salas Gaetgens Luis, Sánchez Pérez Ricard, Altes Vaques Eva, Deixens Martínez Bibiana, Amatller Corominas Marta, Katia Núñez Casillas Dynaida

机构信息

Area Básica de Salud, Dr Carles Ribas-La Marina, Barcelona.

出版信息

Rev Esp Salud Publica. 2005 Jul-Aug;79(4):453-64. doi: 10.1590/s1135-57272005000400003.

DOI:10.1590/s1135-57272005000400003

PMID:16465962

Abstract

BACKGROUND

No studies have been published to date comparing SCORE, REGICOR and Framingham models. This study is aimed at analyzing how the REGICOR and SCORE functions classify cardiovascular risk, their correlation and concordance with Framingham (1998) and whether any differences exist among them with regard to the cardiovascular risk factors in high-risk groups.

METHODS

Descriptive cross-sectional study conducted in primary care. A total of 851 individuals within the 35-74 age range, free of cardiovascular diseases and selected by simple random sampling were included. A study was made of the percentage of high-risk patients with Framingham (> or = 20% ten-year risk), SCORE (> or = 5% ten-year risk) and REGICOR with cutoff points > or = 20%, > or = 15%, > or = 10% and > or = 5% at 10 years, given that with REGICOR > or = 20% there are hardly any high-risk cases. A comparison was drawn between the correlation (Pearson's r) and concordance (Kappa index) of the REGICOR and 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. REGICOR > or = 10% showed a better concordance (Kappa 0.83) than SCORE (Kappa 0.61). On comparing the cardiovascular risk factors of the high-risk cases (> or = 20% Framingham, > or = 5% SCORE and > or = 10% REGICOR), SCORE showed higher prevalence of diabetes and a lower prevalence of hypercholesterolemia (p<0.05).

CONCLUSIONS

REGICOR showed a good correlation with Framingham. With the > or = 10% cutoff point, it classifies a number of individuals as high-risk similar to SCORE and fewer than Framingham. The SCORE model would treat a number of patients similar to the REGICOR > or =10% model with hypolipemiant drugs, however showing lesser evidence of effectiveness of the treatment.

摘要

背景

迄今为止，尚无比较SCORE、REGICOR和弗明汉姆模型的研究发表。本研究旨在分析REGICOR和SCORE函数如何对心血管风险进行分类，它们与弗明汉姆（1998年）的相关性和一致性，以及在高危人群的心血管危险因素方面它们之间是否存在差异。

方法

在初级保健机构进行描述性横断面研究。纳入了851名年龄在35 - 74岁之间、无心血管疾病且通过简单随机抽样选取的个体。研究了弗明汉姆（十年风险≥20%）、SCORE（十年风险≥5%）以及REGICOR在10年时截断点分别为≥20%、≥15%、≥10%和≥5%时高危患者的百分比，因为REGICOR≥20%时几乎没有高危病例。比较了REGICOR和SCORE高危个体与弗明汉姆的相关性（皮尔逊r）和一致性（卡帕指数）。

结果

分别发现的高危百分比为：弗明汉姆为23.3%；SCORE为15.2%；REGICOR在所述截断点时分别为1.4%、5.8%、17.6%和57.0%。REGICOR的相关性为0.99，SCORE的相关性为0.78。REGICOR≥10%显示出比SCORE（卡帕0.61）更好的一致性（卡帕0.83）。在比较高危病例（弗明汉姆≥20%、SCORE≥5%和REGICOR≥10%）的心血管危险因素时，SCORE显示糖尿病患病率较高，高胆固醇血症患病率较低（p<0.05）。