Article

Measurement of total cholesterol is part of cardiovascular disease
risk assessment in primary prevention. Frequently, old total cholesterol values
are available. We assessed whether previously measured total cholesterol values
could be used to estimate cardiovascular disease risk in primary prevention.
DESIGN: A longitudinal analysis using data of a population-based prospective
cohort study (Study of Health in Pomerania) over a period of 10 years. METHODS:
Altogether, 1112 subjects (45% male, mean age 57.8 years, SD +/- 6.8 years)
without prior history of myocardial infarction or stroke were included. We
calculated diagnostic test properties for SCORE-Germany estimates using 5- and
10-year-old total cholesterol values to predict high (>/=5%) cardiovascular
disease risk using estimates based on current total cholesterol as a gold
standard. RESULTS: Mean total cholesterol decreased from 5.88 mmol/l (SD +/-
1.21) at baseline to 5.73 mmol/l (SD +/- 1.10) after 10 years. A high
cardiovascular disease risk was found in 3.2% of subjects at baseline, in 4.9%
after 5 years and in 16.2% after 10 years based on current total cholesterol
values. SCORE-estimates using 5-year-old total cholesterol had a sensitivity of
90.9% (95% confidence interval 87.7-94.1) and specificity of 97.2% (95%
confidence interval 96.4-98.0). For 10-year-old total cholesterol, sensitivity
was 94.2% (95% confidence interval 91.6-96.8) and specificity 96.3% (95%
confidence interval 95.3-97.2). CONCLUSIONS: We observed only minor changes of
total cholesterol over time. SCORE-estimates using 5- or 10-year-old total
cholesterol had a high sensitivity, specificity and test accuracy to identify
subjects at high cardiovascular disease risk and resulted in low
misclassification rates.
CI - (c) The European Society of Cardiology 2015.

Langue : ANGLAIS