Acevedo Mónica, Valentino Giovanna, Kramer Verónica, Bustamante María José, Adasme Marcela, Orellana Lorena, Baraona Fernando, Navarrete Carlos
División de Enfermedades Cardiovasculares, Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile,
Departamento de Matemáticas, Universidad de la Serena, La Serena, Chile.
Rev Med Chil. 2017 Mar;145(3):292-298. doi: 10.4067/S0034-98872017000300002.
Recently, the American College of Cardiology and American Heart Association (ACC/AHA) proposed a new cardiovascular risk (CV) score.
To evaluate the new risk score (ACC/AHA 2013) in a Chilean population.
Between 2002 and 2014, body mass index (BMI), waist circumference, blood pressure, lipid profile and fasting blood glucose levels were measured and a survey about CV risk factors was responded by 3,284 subjects aged 40 to 79 years (38% females), living in urban Santiago. ACC/AHA 2013, FRAM and Chilean FRAM scores were calculated. All-cause mortality was determined in July 2014 by consulting the Death Registry of the Chilean Identification Service, with an average follow up of 7 ± 3 years.
The prevalence of risk factors were 78% for dyslipidemia, 37% for hypertension, 20% for smoking, 7% for diabetes, 20% for obesity and 54% for physical inactivity. The mean FRAM, Chilean FRAM and ACC/AHA scores were 8, 3 and 9%, respectively. During follow-up, 94 participants died and 34 deaths were of cardiovascular cause. Participants who died had a higher prevalence of hypertension (p < 0.01) and diabetes (p < 0. 01) and tended to be older (p = 0.06). The FRAM score for 10 years for deceased and surviving patients was 12 and 8%, respectively (p = NS). The figures for the Chilean FRAM were 5 and 2%, respectively (p = 0.09). The figures for the ACC/AHA 2013 score were 33 and 9%, respectively (p = 0.04). According to receiver operating characteristic curves, ACC/AHA 2013 had a higher area under de curve for CV mortality than FRAM and Chilean FRAM.
The new ACC/AHA 2013 score, is better than traditional FRAM and Chilean FRAM scores in predicting cardiovascular mortality in a low risk population.
最近，美国心脏病学会和美国心脏协会（ACC/AHA）提出了一种新的心血管风险（CV）评分。
在智利人群中评估新的风险评分（ACC/AHA 2013）。
在2002年至2014年期间，测量了3284名年龄在40至79岁（38%为女性）、居住在圣地亚哥市区的受试者的体重指数（BMI）、腰围、血压、血脂谱和空腹血糖水平，并对心血管危险因素进行了调查。计算了ACC/AHA 2013、FRAM和智利FRAM评分。2014年7月通过查询智利身份识别服务处的死亡登记处确定全因死亡率，平均随访时间为7±3年。
危险因素的患病率分别为血脂异常78%、高血压37%、吸烟20%、糖尿病7%、肥胖20%和身体活动不足54%。FRAM、智利FRAM和ACC/AHA评分的平均值分别为8%、3%和9%。在随访期间，94名参与者死亡，34例死亡为心血管原因。死亡参与者的高血压患病率更高（p<0.01）和糖尿病患病率更高（p<0.01），且年龄偏大（p=0.06）。死亡患者和存活患者的10年FRAM评分分别为12%和8%（p=无显著性差异）。智利FRAM的数字分别为5%和2%（p=0.09）。ACC/AHA 2013评分的数字分别为33%和9%（p=0.04）。根据受试者工作特征曲线，ACC/AHA 2013在预测心血管死亡率方面的曲线下面积高于FRAM和智利FRAM。
新的ACC/AHA 2013评分在预测低风险人群的心血管死亡率方面优于传统的FRAM和智利FRAM评分。
