Background. Based on studies carried out in an Italian general population (Cuore project), the “Istituto Superiore di Sanità” of Italy developed an Italian algorithm for the calculation of the global cardiovascular risk (Cuore Risk Score; CRS). Although already validated in other Italian general population samples, little is known about its validity when applied in selected population of patients at high risk of cardiovascular disease. Aim of the study. To assess the accuracy of CRS as predictor of subclinical atherosclerosis and cardiovascular events in a selected population of Italian dyslipidemic patients. Methods. The study was carried out in a group of 1657 patients attending the “E. Grossi Paoletti” Lipid Clinic in Milan. The agreement between CRS and Framingham Risk Score (FRS) was evaluated by correlating the two algorithms each other and by comparing their role as determinant of carotid intima media thickness (IMT). Finally, the predictive capacity of both CRS and FRS were compared to the incidence actually observed in a subgroup of 651 patients followed up from a clinical point of view for about 5 years. Results. The linear correlation analysis between CRS and FRS showed a clear disagreement between the two algorithms. In fact, among the patients classified at low risk (<10%) by CRS, 38% was classified at intermediate risk (10-20%) and 7% at high risk (>20%) by FRS. Similarly, 57% of patients classified at intermediate risk by CRS was classified at high risk by FRS. The correlation analysis between CRS, FRS and subclinical atherosclerosis (carotid IMT) showed that the disagreement between the two algorithms was of about 6 percentage points. The comparison between the incidence of cardiovascular events predicted by CRS and FRS and that actually observed in 5 years of follow up showed that CRS underestimated the risk of about 6 percentage points, whereas the FRS seemed to be much more reliable. Augmenting of 6 percentage points each individual CRS, the estimated risk became identical to that obtained with FRS and much more accurate as predictor of both subclinical atherosclerosis and vascular events. Conclusions. In a selected population of Italian dyslipidemic patients, CRS, but not FRS, underestimates the global cardiovascular risk of about 6 percentage points
Algorithm developed by the Italian “Istituto Superiore di Sanità” (Cuore Risk Score) : assessment of its capacity to predict global cardiovascular risk in dyslipidemic patients / S. Castelnuovo, B. Frigerio, M. Amato, A. Ravani, E. Tremoli, C.R. Sirtori, D. Baldassarre. - In: NMCD. NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES. - ISSN 0939-4753. - 18:1(2008), pp. S5-S5. (Intervento presentato al 21. convegno National Congress of the Italian Society for the Study of Arteriosclerosis (SISA) tenutosi a Perugia nel 2007).
Algorithm developed by the Italian “Istituto Superiore di Sanità” (Cuore Risk Score) : assessment of its capacity to predict global cardiovascular risk in dyslipidemic patients
S. CastelnuovoPrimo
;B. FrigerioSecondo
;E. Tremoli;C.R. SirtoriPenultimo
;D. BaldassarreUltimo
2008
Abstract
Background. Based on studies carried out in an Italian general population (Cuore project), the “Istituto Superiore di Sanità” of Italy developed an Italian algorithm for the calculation of the global cardiovascular risk (Cuore Risk Score; CRS). Although already validated in other Italian general population samples, little is known about its validity when applied in selected population of patients at high risk of cardiovascular disease. Aim of the study. To assess the accuracy of CRS as predictor of subclinical atherosclerosis and cardiovascular events in a selected population of Italian dyslipidemic patients. Methods. The study was carried out in a group of 1657 patients attending the “E. Grossi Paoletti” Lipid Clinic in Milan. The agreement between CRS and Framingham Risk Score (FRS) was evaluated by correlating the two algorithms each other and by comparing their role as determinant of carotid intima media thickness (IMT). Finally, the predictive capacity of both CRS and FRS were compared to the incidence actually observed in a subgroup of 651 patients followed up from a clinical point of view for about 5 years. Results. The linear correlation analysis between CRS and FRS showed a clear disagreement between the two algorithms. In fact, among the patients classified at low risk (<10%) by CRS, 38% was classified at intermediate risk (10-20%) and 7% at high risk (>20%) by FRS. Similarly, 57% of patients classified at intermediate risk by CRS was classified at high risk by FRS. The correlation analysis between CRS, FRS and subclinical atherosclerosis (carotid IMT) showed that the disagreement between the two algorithms was of about 6 percentage points. The comparison between the incidence of cardiovascular events predicted by CRS and FRS and that actually observed in 5 years of follow up showed that CRS underestimated the risk of about 6 percentage points, whereas the FRS seemed to be much more reliable. Augmenting of 6 percentage points each individual CRS, the estimated risk became identical to that obtained with FRS and much more accurate as predictor of both subclinical atherosclerosis and vascular events. Conclusions. In a selected population of Italian dyslipidemic patients, CRS, but not FRS, underestimates the global cardiovascular risk of about 6 percentage pointsFile | Dimensione | Formato | |
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