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Hipertens Riesgo Vasc. 2019 Mar 26. pii: S1889-1837(19)30017-0. doi: 10.1016/j.hipert.2019.02.002. [Epub ahead of print]

[Validation of the SCORE index and SCORE for old people in the Castilla y Léon cardiovascular disease risk cohort].

[Article in Spanish]

Author information

1
Consejería de Sanidad, Dirección General de Salud Pública, Valladolid, España.
2
Consejería de Sanidad, Dirección General de Salud Pública, Valladolid, España. Electronic address: orddiean@jcyl.es.
3
Consejería de Sanidad, Gerencia Regional de Salud, Dirección General de Asistencia Sanitaria, Valladolid, España.

Abstract

INTRODUCTION AND OBJECTIVES:

The Systematic Coronary Risk Evaluation (SCORE) is the most extended index in Europe for overall cardiovascular risk assessment. This study aims to validate the calculated risk with the observed 10-year cardiovascular mortality in a population cohort aged 40 to 75 years.

METHODS:

In 2014 the SCORE and the SCORE OP (for older people) were calculated in a population aged 40 to 64 years-old and 65 to 75 years-old, respectively. In 2014 the 10-year mortality was estimated with the Kaplan-Meier estimator and survival model. Sensitivity, specificity, predictive values, risk ratio of a SCORE value≥5%, and the area under the curve (C statistic) were calculated.

RESULTS:

Cardiovascular mortality estimated by SCORE was 3 times higher than the observed mortality. The sensitivity of a SCORE≥5% was 20% in women and 28.6% in those less than 65 years old. Predictive positive values were also low, particularly in women with 0.6%. Neither women nor those aged less than 65 years had a significant C statistic.

CONCLUSIONS:

The SCORE index does not suitably reflect the cardiovascular mortality pattern in Castilla y León. The prediction models for morbidity and mortality need to be periodically updated in order to adjust the prevention and treatment protocols. The SCORE OP has better validity parameters than the SCORE calculated below that age.

KEYWORDS:

Cardiovascular diseases; Enfermedades cardiovasculares; Evaluación de riesgo; Mortalidad; Mortality; Risk assessment

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