Fontenelle Leonardo Ferreira, Sarti Thiago Dias, Quinte Gabriela Callo, Almeida Ana Paula Santana Coelho, Mill José Geraldo
Universidade Federal do Espírito Santo (UFES) Departamento de Medicina Social, Vitoria, ES - Brasil.
Universidade Federal do Espírito Santo (UFES) Programa de Pós-Graduação em Saúde Coletiva, Vitoria, ES - Brasil.
Arq Bras Cardiol. 2025 Jul 28;122(6):e20240405. doi: 10.36660/abc.20240405. eCollection 2025.
The Framingham risk score and Pooled Cohort Equations (PCE) have never been recalibrated for the Brazilian population. In contrast, the Globorisk-LAC score was recently derived using a methodology analogous to the PCE and has been recalibrated for Latin American countries.
To describe the agreement between the Framingham, PCE, and Globorisk-LAC scores in estimating the 10-year cardiovascular risk in the Brazilian population.
This cross-sectional study used the three scores to estimate cardiovascular risk in participants aged 40 to 74 years without a history of cardiovascular disease based on data from the 2013 National Health Survey (PNS). The agreement was estimated as (i) the percentage of participants in which the risk estimated by one score was between 0.80 and 1.25 times the risk estimated by another score and (ii) based on the Gwet's agreement coefficient (AC1) according to risk categories (low, intermediate, and high).
A total of 4,416 participants were included from 8,952 participants from the PNS with a laboratory component. The median (interquartile range) of the estimated 10-year cardiovascular risk was 9.2% (5.1 to 17.8) according to the Framingham, 3.6% (1.7 to 8.2) according to the PCE, and 4.7% (2.8 to 8.1) according to the Globorisk-LAC. The risk estimated using the Framingham agreed with the Globorisk-LAC and PCE in 6.4% and 1.8% of the cases, respectively, whereas the PCE and Globorisk-LAC agreed in 34.7% of the cases. When considering the risk stratification, the respective AC1 values were 0.454, 0.489, and 0.874.
The three cardiovascular risk scores showed low levels of agreement with each other. The reasons for this disagreement suggests that Globorisk-LAC is a strong candidate to replace the Framingham in the Brazilian guidelines for dyslipidemia.
弗雷明汉风险评分和合并队列方程（PCE）从未针对巴西人群进行重新校准。相比之下，全球风险-拉丁美洲（Globorisk-LAC）评分最近采用了与PCE类似的方法得出，并已针对拉丁美洲国家进行了重新校准。
描述弗雷明汉、PCE和Globorisk-LAC评分在估计巴西人群10年心血管疾病风险方面的一致性。
这项横断面研究使用这三种评分，根据2013年全国健康调查（PNS）的数据，对40至74岁无心血管疾病史的参与者的心血管疾病风险进行估计。一致性评估如下：（i）一个评分估计的风险在另一个评分估计风险的0.80至1.25倍之间的参与者百分比；（ii）根据风险类别（低、中、高）基于格韦特一致性系数（AC1）。
在PNS的8952名有实验室检测项目的参与者中，共纳入了4416名参与者。根据弗雷明汉评分，估计的10年心血管疾病风险的中位数（四分位间距）为9.2%（5.1至17.8），根据PCE为3.6%（1.7至8.2），根据Globorisk-LAC为4.7%（2.8至8.1）。使用弗雷明汉评分估计的风险分别在6.4%和1.8%的病例中与Globorisk-LAC和PCE一致，而PCE和Globorisk-LAC在34.7%的病例中一致。考虑风险分层时，各自的AC1值分别为0.454、0.489和0.874。
这三种心血管疾病风险评分之间的一致性水平较低。这种不一致的原因表明，在巴西血脂异常指南中，Globorisk-LAC是取代弗雷明汉评分强有力的候选者。
