Evaluation of Coronary Risk Score Applications in 10-Year Coronary Heart Risk Estimation
Atherosclerosis is a multifactorial disease with risk factors that have multiple effects. In the identification and treatment of asymptomatic individuals at high risk for developing coronary heart disease (CHD) different risk scoring schemes are used in everyday routine. The aim of this study was to compare SCORE recommended for our country with two other most frequently used risk schemes for 10-year CHD risk evaluation: Framingham and PROCAM as well as their modifications. From 220 examined subjects of both sexes, who were treated mainly for lipid metabolism disorder at the Dispensary for Atherosclerosis Prevention, Centre for Laboratory Medicine, Clinical Centre of Vojvodina, 110 subjects were included in our study and agreed to a one-year follow-up. At first check-up, 15% had low risk according to Framingham Weibull and 78% according to PROCAM, intermediate 12% according to PROCAM NS up to 45% according to Framingham Weibull, and high 8% according to PROCAM up to 40% according to Framingham Weibull. After a one-year treatment 30% were in the low risk category according to Framingham Weibull and 88% according to PROCAM. Intermediate from 10% according to PROCAM to 36% according to Framingham Weibull, and high from 2% according to PROCAM to 25% according to Framingham Weibull. There is a significantly lower percentage of high risk individuals and a higher percentage of low risk individuals after one year of lipid disorder treatment.
Ostojić M. Preporuke za prevenciju ishemijske bolesti srca. Prvo izdanje, Beograd: Ministarstvo zdravlja republike Srbije; 2002.
The Expert Panel. The Third Report of the National Cholesterol Education Program (NCEP), Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Tratment Panel III). Final report. Circulation 2002; 106: 3143-421.
Backer G, Ambrosioni E, Borch-Johansen K, Brotons C, Cifkova R, Dallongeville J, et al. European guidelines on cardiovascular disease prevention in clinical practice. Third joint task force of European and other societies on cardiovascular prevention in clinical practice. Eur J Cardiovas Prev Rehabil 2003; 10 (Suppl 1) S1-78.
International Task Force for Prevention of Coronary Heart Disease. Pocket Guide to Prevention of Coronary Heart Disease, 1st ed. Grunnnald: 2003.
Grundy SM, Cleeman JI, Mertz NB, Brewer B, Clark L, Hunninghake D, et al. Implications of recent clinical trials for National Cholesterol Education Program Adult Treatment Panel III Guidelines. JACC 2004; 44 (3): 720-32.
Sarti C, Gallagher J. The metabolic syndrome. J Diabetes Complicat 2006; 20 (2): 121-32.
Assman G, Cullen P, Shulte H. Simple scoring scheme for calculating the risk of acute coronary events based on the 10-year follow-up of the Prospective Cardiovascular Munster (PROCAM) study. Circulation 2002; 105: 310-15.
Assman G, Cullen P, Shulte H. The Munster Heart Study (PROCAM): Results of follow-up at 8 years. Eur Heart J 1998; 19 (Suppl A): A2-A11.
Conroy RM, Pyörälä K, Fitzgerald AP, Sams S, Meniotti A, Backer G, et al. Estimation of ten-year risk of fatal cardiovascular disease in Europe: The SCORE Project. Eur Heart J 2003; 24: 987-1003.
Erhardt LR, Gotto A. The Evolution of European Guidelines: changing the management of cholesterol levels. Atherosclerosis 2006; 185 (1): 12-20.
Graham I, Atar D, Borch-Johansen K, Boysen G, Burrel G, Cifkova R, et al. European guidelines on cardiovascular disease prevention in clinical practice. Eur J Cardiovas Prev Rehabil 2007; 14 (Suppl 2) S1-113.
Zamaklar M. Konsenzus konferencija o promeni referentnih vrednosti lipida i ciljnim vrednostima lipidskih poremećaja. Jugoslov Med Biohem 2005; 24: 299-300.
Third Report of the National Cholesterol Education Programme (NCEP). Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA Publications 2001; 285 (19): 2486-97.
Grujić V, Jakovljević Đ, eds. Primena statistike u medicinskim istraživanjima. Prvo izdanje. Novi Sad: Medicinski fakultet; 1998.
Cristobal J, Lago F, De la Fuente J, Gonzalez-Juanatey J, Vazquez-Belles P, Vila M. Comparison of Coronary Risk Estimation Derived Using the Framingham and REGICOR Equations. Rev Esp Cardiol 2005; 58 (8): 910-5.
Vekić J, Topić A, Zeljković A, Jelić-Ivanović Z, Spasojević-Kalimanovska V. LDL and HDL subclasses and their relationship with Framingham risk score in middleaged Serbian population. Clin Biochem 2007; (40): 310-6.
Jovičić S, Ignjatović S, Majkić-Singh N. Comparison of two different methods for cardiovascular risk assessment: Framingham Risk Score and SCORE System. Journal of Med Bioh 2007; 26 (2): 94-7.
Topol EJ, Lauer M. The rudimentary phase of personalised medicine: coronary risk scores. Lancet 2003; 362: 1776-7.
Empana JP, Ducimetriere P, Arveiler D, Ferrieres J, Evans A, Ruidavets JB, et al. Are the Framingham and PROCAM coronary heart disease risk functions applicable to different European populations? Eur Heart J 2003; 24: 1903-11.