Article

Risk prediction models for cardiovascular death are important for
providing advice on lifestyle and in decision-making regarding primary preventive
drug treatment. The latest Swedish version of the Systematic COronary Risk
Evaluation (SCORE 2015) has yet not been tested in the population.
The objective of this study was to estimate the prevalence of high and very high risk
of fatal cardiovascular disease (CVD) of the current population according to 2015
SCORE Sweden and to evaluate the predictive accuracy of the 2003 Swedish version
of SCORE (2003 SCORE Sweden) and 2015 SCORE Sweden in a population with declining
CVD mortality. METHODS: We estimated the high and very high risk group for
cardiovascular death for individuals 40-65 years of age in the 2014 Northern
Sweden MONICA population survey excluding subjects with known diabetes or
previous CVD (n = 813). Using the 1999 MONICA survey (n = 3347) followed up for
10 years for CVD mortality, we assessed the calibration of both 2003 and 2015
SCORE Sweden. RESULTS: In 2014 2.6% of the population was considered at high or
very high risk for fatal CVD, 95% were men and 76% were in the age group 60-65
years. Including subjects with a single markedly elevated risk factor, known
diabetes or CVD, 12% of the population was at high or very high risk. During 10
years of follow-up of the 1999 cohort, 34 CVD deaths (24 men and 10 women)
occurred. The 2003 SCORE overestimated the risk of death from CVD (ratio
predicted/observed 2.3, P < 0.001) whereas the 2015 SCORE slightly overestimated
the number of deaths (predicted/observed 1.3, P = 0.12). The 2015 SCORE predicted
more accurately than the 2003 SCORE the number of deaths in the different risk
and age categories. CONCLUSION: The 2015 SCORE Sweden more adequately than 2003 SCORE Sweden predicts the number of deaths. In 2014, the proportion of high-risk
individuals is small in northern Sweden. The main use of 2015 SCORE Sweden would
therefore be as an educational tool between the physician and people without diabetes or CVD in a consultation regarding cardiovascular risk.
CI - (c) The European Society of Cardiology 2016.

Langue : ANGLAIS