Table 2Risk scoring methods for use in primary prevention

Method of derivationOutcomePrediction periodPractical methodAgeSexBPLipidsSmokingLVHDiabetesOther risk factors
ARIC diabetes24Proportional hazards regressionCHD10 yearsEquationAgeSexSBP Antihypertensive medicationTotal cholesterol
HDL cholesterol
SmokingLVHDiabetics onlyRace
BMI
Waist hip ratio
Sports activities
Keys score
Serum creatinine
Serum albumin
WBC count
Factor VIII
Mean IMT
Bombay25Stepwise linear discriminant analysisCHD4 yearsEquationAgeSexHypertensionApo B
Apo A-1
Smoking/chewing tobaccoDiabetesTotal plasma protein
BMI
Family history
British Regional Heart Study26Multiple logistic regressionMI/sudden ischaemic death5 yearsPoint scoringAgeMenSBP
DBP
Total cholesterolSmokingDiabetesFamily history
Previous IHD
ECG MI or ischaemia
Angina pectoris
Busselton29;30Logistic regressionCHD death10 yearsEquationAgeSexSBPTotal cholesterolSmokingBMI
Cardiff Type 2 diabetes32Hybrid logistic and recursive partitioning modelCHD4 yearsEquationAgeSexSBPTotal cholesterol
HDL cholesterol
SmokingDiabetics only
Duration of diabetes
Pulse pressure
Carta del
Rischio del PPP33
Multivariate modelCVD3.6 yearsChartsAgeSexSBPHDL cholesterolSmokingDiabetes
CERT WOSCOPS34Cox proportional hazards modelCHD5 yearsTableAgeMenDBPTotal cholesterol
HDL cholesterol
Lipid lowering treatment
SmokingDiabetesFamily history
Angina/nitrate use
Copenhagen stroke36Cox proportional hazards modelStroke10 yearsPoint scoringAgeSexSBP
Antihypertensive medication
SmokingLVHDiabetesAF
Previous CVD
CUORE37Cox proportional hazards modelCHD10 yearsEquationAgeMenSBP
Antihypertensive medication
Total cholesterol
HDL cholesterol
SmokingDiabetesFamily history
DECODE38Cox proportional hazards modelCVD death5 yearsEquationAgeSexSBPTotal cholesterolSmokingDiabetesFasting plasma glucose. Region
Dubbo39Multiple logistic modelCVD5 and 10 yearsEquationAgeSexSBP
Antihypertensive medication
Total cholesterol
HDL cholesterol
SmokingDiabetes
Dundee40Multiple logistic functionCHD5 yearsEquation
Rank
Risk disk
AgemenSBPTotal cholesterolSmoking
ERICA42Multiple logistic functionCHD death6 yearsEquationAgeMenSBPTotal cholesterolSmokingBMI
Region
Family heart study score43Multiple logistic regressionCHDNot specifiedPoint scoringAgeSexSBPTotal cholesterolSmokingDiabetesPrevious IHD
Current angina
Family history
FINE 200244Logistic regressionCHD death
CVD death
10 yearsEquationAgeMenSBP
Antihypertensive medication
Total cholesterol
HDL cholesterol
SmokingLVHDiabetesPast history of CHD/CVD
FINRISK45;46Logistic regressionMI or CHD death10 yearsEquationAgeSexSBPTotal cholesterol
HDL cholesterol
SmokingDiabetes
Framingham-Abbott47Multiple logistic regressionCVD
CHD
CHD death
MI
Stroke
8 yearsTablesAgeSexSBP
DBP
Total cholesterolSmokingLVHDiabetes
Framingham-Anderson 199148;49Non-proportional hazards
Weibull accelerated failure time model
MI
CHD death
CHD
Stroke
CVD
CVD death
4–12 yearsRegression equation
Point scoring
AgeSexSBP
DBP
Total cholesterol
HDL cholesterol
SmokingLVHDiabetes
Framingham-D’Agostino 200050Weibull accelerated failure time modelCHD1–4 yearsRegression equation
Point scoring
AgeSexSBP
Antihypertensive medication
Total cholesterol
HDL cholesterol
Triglycerides
SmokingDiabetesBMI
Menopausal status
Alcohol intake
Framingham-Laurier 199552;53Recalibration of Framingham-AndersonCHD5 yearsEquation
Point scoring
AgeMenSBPTotal cholesterol
HDL cholesterol
SmokingLVHDiabetes
Framingham-Levy55Multiple logistic regressionCHD10 yearsAgeSexSBP
DBP
Total cholesterol
HDL cholesterol
SmokingLVHDiabetes
Framingham-McGee56, Shurtleff57, Kannel58Logistic regression modelCVD8–18 yearsEquationAgeSexSBPTotal cholesterolSmokingLVHGlucose tolerance
Framingham-MRFIT59Walker & Duncan logistic modelCHD death
CHD
Death all causes
6 yearsEquationAge 35–57MenDBPTotal cholesterolSmoking
Framingham Odell 199460Non-proportional hazards
Weibull accelerated failure time model
CHD Stroke (ABI)
MI
Heart attack
CVD
MI or stroke (ABI)
Sudden death
20 yearsEquationAgeSexSBPTotal cholesterolSmokingRelative weight
Framingham-Wilson 199861Cox proportional hazards modelCHD
Hard CHD
10 yearsPoint scoringAgeSexSBP
DBP
Total cholesterol or LDL cholesterol
HDL cholesterol
SmokingDiabetes
Framingham-Wolf 199165
D’Agostino 199466 (stroke)
Cox proportional hazards modelStroke10 yearsPoint scoring
Equation
AgeSexSBP
Antihypertensive medication
SmokingLVHDiabetesAF
CVD
Global coronary risk score67Not describedCHDNot specifiedPoint scoringAgeSBPTotal cholesterol
HDL cholesterol
Smoking
Glostrup68Cox regressionMI
CVD
All causes of death
10 yearsEquationAge 50SexDiastolic blood pressureTotal cholesterolSmokingFasting glucoseRelative weight
Ischaemia on ECG
Job activity
Number of rooms
GREAT27None describedCVDNone specifiedChartAgeSBP
DBP
Total cholesterol
HDL cholesterol
Triglycerides
SmokingLVHMenopausal status
Family history
BMI
Diabetic or renal disease
History of atherosclerotic disease
GRIPS 199069Multiple logistic regressionCHD (CAD)
Fatal MI
Non-fatal MI
Sudden coronary death
Chronic CHD
5 yearsDecision aidMenSBP
DBP
LDL cholesterol
VLDL cholesterol
HDL cholesterol
Apo A1
Triglycerides
SmokingBlood glucoseFamily history
Alcohol intake
Physical activity
INDANA70Cox proportional hazards modelCVD death5 yearsPoint scoringAgeSexSBPTotal cholesterolSmokingLVHDiabetesHeight Creatinine
History of MI
History of stroke
International Cooperative
Study on Cardiovascular Epidemiology71
Multiple logistic regressionCHD5 yearsEquationAgeMenSBPTotal cholesterolSmokingBMI
USA or Europe
Italian cohorts of the Seven countries study 198572Multiple logistic functionCHD20 yearsEquationAgeMenSBPTotal cholesterolSmokingBMI
Physical activity
Italian cohorts of the Seven countries study 199073Log-linear model incorporating
Weibull distribution; accelerated failure time model
CVD25 yearsTablesAgeMenSBPTotal cholesterolSmokingDiabetes
John Hopkins74Cox proportional hazards regressionCHD30 yearsEquationAgeTotal cholesterolSmokingFamily history
Kaiser Permanente 199575Not describedCVDNot specifiedComputer programAgeSexHypertensionLDL cholesterol
HDL cholesterol
SmokingDiabetes
Luoto76Not describedCVDNot specifiedPoint scoringAgeSexHypertensionTotal cholesterol
HDL cholesterol
SmokingBMI
Physical activity
McManus 198677Weighting of risk based on known degrees of associationCHDNot specifiedPoint scoringAgeSexSBP
DBP
Total cholesterol
HDL cholesterol
SmokingDiabetes durationFamily history
MRFIT CHD prevention model78Multivariate analysisCHD death
All causes of death
6 yearsEquationAgeMenDiastolic blood pressureTotal cholesterolSmoking
Nagpur79Multiple logistic regressionCHDPoint scoring
Equation
HypertensionTotal cholesterolDiabetesPhysical activity
Socio-economic status
North Karelia80Not describedCVD mortalityNot specifiedEquationAgeSexDiastolic blood pressureTotal cholesterolSmoking
Northwick Park81Multiple linear regressionCHD5 yearsEquationMenSBPTotal cholesterolSmoking(A version includes fibrinogen and Factor VIIc)
Olmsted County82Cox proportional hazards modelCVD2 yearsPoint scoringAgeSexSystemic hypertensionLVHDiabetesOther ECG variables
Paris Prospective Study 197683Lellouch exponential modelCHD4 yearsEquationMenSBPTotal cholesterolSmokingLVHDiabetesECG variables
Paris Prospective Study 198184Logistic regressionCHD7 yearsEquationAgeSBPTotal cholesterolSmokingDiabetes
Physicians’ Health Study85Cox proportional hazards modelCVD13 yearsEquationAgeMenSBP
DBP
Antihypertensive medication
SmokingDiabetesBMI
Family history
Exercise
Alcohol intake
Plovdiv86Regression modelIHDNot specifiedEquationSexDBPTotal cholesterolBlood sugar
PRECARD87Cox regression modelFatal/non-fatal MI10 yearsComputer program EquationSexSBPTotal cholesterol
HDL cholesterol
SmokingDiabetesBMI
Previous MI
Family history
PROCAM Assmann 199389Logistic function analysisCHD6 yearsEquationAgeMenSBPTotal cholesterol
HDL cholesterol
SmokingDiabetesFamily history
Angina pectoris
PROCAM Assmann 199791Multiple logistic functionCHD8 yearsEquationAgeMenSBPTotal cholesterol
LDL cholesterol
HDL cholesterol
Triglycerides
SmokingGlucose intoleranceFamily history
PROCAM Assmann 199892, Cullen 199893Multiple logistic regressionCHD8 yearsEquation
Risk factor counting
AgeMenSBPTotal cholesterol
LDL cholesterol
HDL cholesterol
Triglycerides
SmokingGlucose intoleranceFamily history
Angina pectoris
PROCAM
Assmann Circulation 200295, Assmann 200396
Cox proportional hazards modelCHD10 yearsPoint scoringAgeMenSBPTotal cholesterol
HDL cholesterol
Triglycerides
SmokingDiabetesFamily history
Region
PROCAM
Voss 200297
Multi-layer perceptron network Probalistic neural networkCHD10 yearsPoint scoringAgeMenSBP
Hypertension (personal or family history)
Total cholesterol
HDL cholesterol
Triglycerides
SmokingDiabetesFamily history
Height γ glutamyl transferase
BMI
II Progetto
Romano di
Prevenzione della
Cardiopatia Coronarica98
Multiple logistic functionCHDNot specifiedPoint score
Equation
AgeMenSBPTotal cholesterolSmokingWork activity
Rasmusen Centre99Non describedCVDNot specifiedPoint scoringAgeSexHistory of high blood pressureHistory of high cholesterolSmokingHistory of high blood sugarFamily history of premature
CVD or diabetes
Early markers of arterial and cardiac disease
RCV-ap100Recalibration of Framingham-Kannel 1976CVDNot specifiedPoint scoringAgeSexSBPTotal cholesterolSmokingDiabetes
REGICOR101Recalibration of Framingham Wilson for Spanish populationCHD death or non fatal MI10 yearsEquationAgeSexHypertensionTotal cholesterol
HDL cholesterol
SmokingDiabetes
RIFLE102Cox proportional hazards modelCHD death6 yearsEquationAgeMenSBPTotal cholesterolSmoking
RISCARD 103;104Log-linear model incorporating
Weibul hazard distribution; accelerated failure time model
Hard CHD
Hard CVD
Hard cerebro-vascular
5 yearsComputer programAgeSexMean blood pressureNon-HDL cholesterol (calculated from total cholesterol-HDL cholesterol)
HDL cholesterol
SmokingDiabetesBMI
Heart rate
Rotterdam 2003
Nijhuis106
Cox proportional hazards regressionCVD
CHD
Stroke
5 yearsEquationBlood pressureMedical history
Laboratory tests
Medication use
Mild CVD
Rotterdam 2002
Nijhuis105
Regression modelCHD10 yearsEquationAgeSexSBP
Antihypertensive medication
Total cholesterol
HDL cholesterol
SmokingDiabetesFamily history
Angina pectoris IC (ABI)
Royal College of Physicians of Edinburgh
Diabetes research group107
Cox Proportional hazards modelMacro-vascular disease6–9 yearsRisk score
Equation
AgeSBP
DBP
Total cholesterolSmokingDiabetics only
HbA1c
Urinary albumin
SCORE108Weibull proportional hazards modelCVD death10 yearsChartsAgeSexSBPTotal cholesterol
HDL cholesterol
SmokingHigh or low risk population
UKPDS111Maximal likelihood estimation
Fully parametric model
Fatal MI/sudden death20 yearsInternet resource
Equation
AgeSexSBPTotal cholesterol
HDL cholesterol
SmokingDiabetics only
HbA1c
Ethnicity
US-Railway115Multiple logistic regressionMI (fatal or non-fatal)5–20 yearsComputer program
Risk disk Equation
AgeMenDBPTotal cholesterolSmoking
West Dorset116None describedCHDNone specifiedPoint scoringAgeSexPatient reported blood pressureSmokingMeat consumption
Stress
Exercise
Weight
Family history
Westlund score117Product of relative risksMI10 yearsSexSBPTotal cholesterolSmokingFamily history
WHO 1974120None describedCHDNot specifiedPoint scoringAgeMenSBPTotal cholesterolSmokingJob activity
Women’s Health Study 200285Cox proportional hazards modelCVD6 yearsEquationAgeWomenSBP
Antihypertensive medication
SmokingDiabetesBMI
Family history
Exercise
Alcohol intake
Zoetermeer121Proportional hazardsDeath all causes11.5 yearsEquationAgeSBP
Antihypertensive medication
SmokingDiabetesBMI
Pulse rate
Previous MI

From: Risk scoring methods designed to identify people at high risk of cardiovascular disease

Cover of A Systematic Review of Risk Scoring Methods and Clinical Decision Aids Used in the Primary Prevention of Coronary Heart Disease (Supplement)
A Systematic Review of Risk Scoring Methods and Clinical Decision Aids Used in the Primary Prevention of Coronary Heart Disease (Supplement) [Internet].
NICE Clinical Guidelines, No. 67S.
Beswick AD, Brindle P, Fahey T, et al.
Copyright © 2008, Royal College of General Practitioners.

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