Gabriel Rafael, Brotons Carlos, Tormo M José, Segura Antonio, Rigo Fernando, Elosua Roberto, Carbayo Julio A, Gavrila Diana, Moral Irene, Tuomilehto Jaakko, Muñiz Javier
Unidad de Epidemiología Clínica, Instituto IdiPAZ, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, Spain; Red de Investigación Cardiovascular (RIC), Spain.
Red de Investigación Cardiovascular (RIC), Spain; Unidad de Investigación, EAP Sardenya-IIB Sant Pau, Barcelona, Spain.
Rev Esp Cardiol (Engl Ed). 2015 Mar;68(3):205-15. doi: 10.1016/j.rec.2014.03.019. Epub 2014 Aug 22.
In Spain, data based on large population-based cohorts adequate to provide an accurate prediction of cardiovascular risk have been scarce. Thus, calibration of the EuroSCORE and Framingham scores has been proposed and done for our population. The aim was to develop a native risk prediction score to accurately estimate the individual cardiovascular risk in the Spanish population.
Seven Spanish population-based cohorts including middle-aged and elderly participants were assembled. There were 11800 people (6387 women) representing 107915 person-years of follow-up. A total of 1214 cardiovascular events were identified, of which 633 were fatal. Cox regression analyses were conducted to examine the contributions of the different variables to the 10-year total cardiovascular risk.
Age was the strongest cardiovascular risk factor. High systolic blood pressure, diabetes mellitus and smoking were strong predictive factors. The contribution of serum total cholesterol was small. Antihypertensive treatment also had a significant impact on cardiovascular risk, greater in men than in women. The model showed a good discriminative power (C-statistic=0.789 in men and C=0.816 in women). Ten-year risk estimations are displayed graphically in risk charts separately for men and women.
The ERICE is a new native cardiovascular risk score for the Spanish population derived from the background and contemporaneous risk of several Spanish cohorts. The ERICE score offers the direct and reliable estimation of total cardiovascular risk, taking in consideration the effect of diabetes mellitus and cardiovascular risk factor management. The ERICE score is a practical and useful tool for clinicians to estimate the total individual cardiovascular risk in Spain.
在西班牙，基于大规模人群队列且足以准确预测心血管风险的数据一直很匮乏。因此，有人提议并针对我国人群对欧洲心脏手术风险评估系统（EuroSCORE）和弗雷明汉心脏风险评估系统（Framingham scores）进行校准。目的是开发一种本土风险预测评分，以准确估计西班牙人群个体的心血管风险。
收集了七个基于西班牙人群的队列，其中包括中年和老年参与者。共有11800人（6387名女性），随访时间达107915人年。共识别出1214例心血管事件，其中633例为致命事件。进行了Cox回归分析，以检验不同变量对10年总心血管风险的影响。
年龄是最强的心血管风险因素。收缩压高、糖尿病和吸烟是强有力的预测因素。血清总胆固醇的影响较小。抗高血压治疗对心血管风险也有显著影响，男性的影响大于女性。该模型显示出良好的辨别力（男性的C统计量=0.789，女性的C=0.816）。分别为男性和女性绘制了风险图表，以图形方式展示10年风险估计值。
ERICE是一种基于西班牙多个队列的背景和同期风险得出的针对西班牙人群的新型本土心血管风险评分。ERICE评分考虑了糖尿病和心血管危险因素管理的影响，能够直接且可靠地估计总心血管风险。对于临床医生而言，ERICE评分是估计西班牙个体总心血管风险的实用且有用的工具。
