Buitrago Ramírez Francisco, Cañón Barroso Lourdes, Díaz Herrera Natalio, Cruces Muro Eloísa, Bravo Simón Belén, Pérez Sánchez Ignacio
Unidad Docente de Medicina Familiar y Comunitaria, Centro de Salud Universitario La Paz, Badajoz, España.
Med Clin (Barc). 2006 Sep 16;127(10):368-73. doi: 10.1157/13092437.
Framingham-REGICOR and SCORE (Systematic Coronary Risk Evaluation) are 2 functions charts recommended to estimate the cardiovascular risk stratification in Spain. The aim of the present study was to validate to 10 years the SCORE and REGICOR functions charts in 40 to 65 years old population.
608 patients (56.7% female) with non evidence of cardiovascular disease were included in the present study. Patients were classified as high risk by REGICOR (> or = 10%) and by SCORE (> or = 5%) functions.
The 90.6% of the population (551 subjects) did not experienced any cardiovascular events during the 10 years follow-up. The REGICOR function chart underestimated the coronary risk (4.9% vs 7.9%; p < 0.001), whereas the SCORE overestimated the cardiovascular risk of death (2.1% vs 1.5%; p < 0.001). In the SCORE function, the average risk of patients with events was 6.1%, whereas the average risk of patients without events was 2.0% (p < 0.001) and 7.1% vs 4.8% (p < 0.001) in the REGICOR equation. The SCORE function obtained better validity criteria than REGICOR with a sensibility of 66.7% (95% confidence interval [CI], 66.2-67.2), especificity of 91.7%, (95% CI, 91.2-92.2) positive likelihood ratio of 8 (95% CI, 7.5-8.5), and eficacy of 91.1% (95% CI, 90.6-91.6). These results were observed in both sexes: women -sensibility: 33.3% (95% CI, 32.4-34.2); especificity: 97.4% (95% CI, 96.5-98.3)- and men -sensibility: 83.3% (95% CI, 82.7-83.9); especificity: 84.0% (95% CI, 83.4-84.6).
The SCORE equation obtains better validity criteria than the REGICOR equation both in the total population and in males and females separately. These results make the SCORE function a powerful tool to estimate the cardiovascular risk.
弗雷明汉-REGICOR和SCORE(系统性冠状动脉风险评估)是西班牙推荐用于评估心血管风险分层的两个功能图表。本研究的目的是在40至65岁人群中对SCORE和REGICOR功能图表进行为期10年的验证。
本研究纳入了608例无心血管疾病证据的患者(女性占56.7%)。患者根据REGICOR(≥10%)和SCORE(≥5%)功能被分类为高危。
90.6%的人群(551名受试者)在10年随访期间未发生任何心血管事件。REGICOR功能图表低估了冠心病风险(4.9%对7.9%;p<0.001),而SCORE高估了心血管死亡风险(2.1%对1.5%;p<0.001)。在SCORE功能中,发生事件患者的平均风险为6.1%,而未发生事件患者的平均风险为2.0%(p<0.001);在REGICOR方程中分别为7.1%对4.8%(p<0.001)。SCORE功能获得了比REGICOR更好的有效性标准,敏感度为66.7%(95%置信区间[CI],66.2 - 67.2),特异度为91.7%(95%CI,91.2 - 92.2),阳性似然比为8(95%CI,7.5 - 8.5),效能为91.1%(95%CI,90.6 - 91.6)。在男女两性中均观察到这些结果:女性——敏感度:33.3%(95%CI,32.4 - 34.2);特异度:97.4%(95%CI,96.5 - 98.3);男性——敏感度:83.3%(95%CI,82.7 - 83.9);特异度:84.0%(95%CI,83.4 - 84.6)。
SCORE方程在总体人群以及分别在男性和女性中均获得了比REGICOR方程更好的有效性标准。这些结果使SCORE功能成为评估心血管风险的有力工具。