Aspelund Thor, Thorgeirsson Gudmundur, Sigurdsson Gunnar, Gudnason Vilmundur
The Icelandic Heart Association, Kopavogur bLandspitali-University Hospital, Reykjavik, Iceland.
Eur J Cardiovasc Prev Rehabil. 2007 Dec;14(6):761-8. doi: 10.1097/HJR.0b013e32825fea6d.
No data are available on the comparison between an absolute 10-year risk of fatal cardiovascular disease (CVD) and coronary heart disease (CHD) morbidity using the risk assessments of the Systematic Coronary Risk Evaluation (SCORE) project.
Data from the prospective Reykjavik Study of 15,782 patients were used to estimate the 10-year risk of fatal CVD and CHD morbidity in Iceland.
Survival to fatal CVD event was defined as in the SCORE project. Survival to CHD morbidity was defined as having a myocardial infarction, coronary artery bypass graft, or angioplasty. The statistical methodology of SCORE was used.
Relative risk in Iceland was comparable with SCORE results but baseline risk was similar to the low-risk version of SCORE, which contradicted previous suggestions for the countries of northern Europe. Correlation between absolute risk of CHD morbidity and risk for fatal CVD was high (r=0.96), resulting in similar ranking of individuals by risk and discriminatory capacity. This is the first published comparison between total fatal CVD risk and CHD morbidity in a population-based cohort using the current risk assessment guidelines of the European Societies on Coronary Prevention.
Risk for fatal CVD in Iceland has the same characteristics as those in a European nation with results varying in accordance with the SCORE project. The risk estimate to be used, CHD morbidity or fatal CVD, is a choice of clinical preference. The data, however, suggest that 5% high-risk threshold of fatal CVD corresponds to a 12% CHD-morbidity risk, which is a significant change from the conventional reference value of 20%.
尚无关于使用系统性冠状动脉风险评估（SCORE）项目的风险评估来比较致命性心血管疾病（CVD）的绝对10年风险与冠心病（CHD）发病率的数据。
来自对15782名患者的前瞻性雷克雅未克研究的数据用于估计冰岛致命性CVD和CHD发病率的10年风险。
致命性CVD事件的生存情况定义同SCORE项目。CHD发病的生存情况定义为发生心肌梗死、冠状动脉搭桥术或血管成形术。使用SCORE的统计方法。
冰岛的相对风险与SCORE结果相当，但基线风险与SCORE的低风险版本相似，这与之前对北欧国家的建议相矛盾。CHD发病的绝对风险与致命性CVD风险之间的相关性很高（r = 0.96），导致个体按风险和鉴别能力的排名相似。这是首次使用欧洲冠状动脉预防协会的当前风险评估指南，在基于人群的队列中对总致命性CVD风险和CHD发病率进行的比较。
冰岛致命性CVD的风险与欧洲国家具有相同特征，结果根据SCORE项目而有所不同。要使用的风险估计值，即CHD发病率或致命性CVD，是临床偏好的选择。然而，数据表明，致命性CVD的5%高风险阈值对应于12%的CHD发病风险，这与20%的传统参考值有显著变化。
