Centro de Salud Universitario "La Paz", Badajoz, Spain.
Scand J Prim Health Care. 2010 Dec;28(4):242-8. doi: 10.3109/02813432.2010.518407. Epub 2010 Sep 27.
To analyse the 10-year performance of the original Framingham coronary risk function and of the SCORE cardiovascular death risk function in a non-diabetic population of 40-65 years of age served by a Spanish healthcare centre. Also, to estimate the percentage of patients who are candidates for antihypertensive and lipid-lowering therapy.
Longitudinal, observational study of a retrospective cohort followed up for 10 years.
Primary care health centre.
A total of 608 non-diabetic patients of 40-65 years of age (mean 52.8 years, 56.7% women), without evidence of cardiovascular disease were studied.
Coronary risk at 10 years from the time of their recruitment, using the tables based on the original Framingham function, and of their 10-year risk of fatal cardiovascular disease using the SCORE tables.
The actual incidence rates of coronary and fatal cardiovascular events were 7.9% and 1.5%, respectively. The original Framingham equation over-predicted risk by 64%, while SCORE function over-predicted risk by 40%, but the SCORE model performed better than the Framingham one for discrimination and calibration statistics. The original Framingham function classified 18.3% of the population as high risk and SCORE 9.2%. The proportions of patients who would be candidates for lipid-lowering therapy were 31.0% and 23.8% according to the original Framingham and SCORE functions, respectively, and 36.8% and 31.2% for antihypertensive therapy.
The SCORE function showed better values than the original Framingham function for each of the discrimination and calibration statistics. The original Framingham function selected a greater percentage of candidates for antihypertensive and lipid-lowering therapy.
分析原始 Framingham 冠心病风险函数和 SCORE 心血管死亡风险函数在一个西班牙医疗中心服务的 40-65 岁非糖尿病人群中 10 年的表现。此外，还估计了适合接受降压和降脂治疗的患者比例。
对一个随访 10 年的回顾性队列进行的纵向观察性研究。
初级保健医疗中心。
共研究了 608 名年龄在 40-65 岁（平均 52.8 岁，56.7%为女性）、无心血管疾病证据的非糖尿病患者。
采用基于原始Framingham 函数的表格，计算患者在招募后 10 年内的冠心病风险；采用 SCORE 表格，计算患者 10 年内致命心血管疾病的风险。
实际的冠心病和致命心血管事件发生率分别为 7.9%和 1.5%。原始 Framingham 方程高估了 64%的风险，而 SCORE 函数高估了 40%的风险，但 SCORE 模型在区分度和校准度统计方面表现优于 Framingham 模型。原始 Framingham 函数将 18.3%的人群归类为高危人群，而 SCORE 函数则将 9.2%的人群归类为高危人群。根据原始 Framingham 和 SCORE 函数，降脂治疗的候选患者比例分别为 31.0%和 23.8%，降压治疗的候选患者比例分别为 36.8%和 31.2%。
SCORE 函数在区分度和校准度统计方面均优于原始 Framingham 函数。原始 Framingham 函数选择了更多适合接受降压和降脂治疗的候选患者。
