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Acta Medica Colombiana
versão impressa ISSN 0120-2448
Resumo
MANCERA-RINCON, Pedro; GIRAL-GIRALDO, Helman Eduardo; RIZO-TELLO, Víctor Zein e BARRERA-GARAVITO, Édgar Camilo. Concordance between the Framingham ATP III SCORE and ACC/AHA 2013 Scales. En a cohort of patients in a fourth level hospital in 2015. Acta Med Colomb [online]. 2018, vol.43, n.4, pp.192-199. ISSN 0120-2448.
Introduction:
identifying people without established cardiovascular disease at high risk is the goal of primary intervention in cardiovascular prevention. In our environment, multiple scales of cardiovascular risk have been applied; however, in Colombia the only scale validated is Framingham.
Objective:
to estimate the agreement between the Framingham ATP III, SCORE and ACC / AHA 2013 scales for the prediction of cardiovascular risk in patients between 40 and 75 years old in a fourth level institution during 2015.
Material and methods:
cross-sectional observational study in patients aged 40-75 years who attended in 2015 in the general check-up service of a fourth-level hospital. Of 4783 individuals a simple randomized sample of 861 was taken. Cardiovascular risk with the Framingham, SCORE and AHA / ACC2013 scales was calculated. Qualitative variables were described by frequency distributions, quantitative variables with measures of central tendency, and a bivariate analysis was performed with Cohen's Kappa correlation coefficient considering as a good correlation > 60.
Results:
the calculation of cardiovascular risk with each of the scales found for high risk AHA 2013 of 14.6%, Framingham 2.2% and SCORE with 1.1%. For average risk SCORE of 26.9%, AHA 2013 of 17.1% and Framingham of 14.4%, and risk under the estimate was of Framingham of 83.3%, SCORE of 73% and AHA 2013 68.3%. The Cohen's Kappa concordance index for high cardiovascular risk between the modified Framingham scale and SCORE evidence a moderate concordance strength (Kappa: 0.47); when calculating this index between modified Framingham and AHA 2013 concordance strength is weak (Kappa: 0.3497).
Conclusion:
with the findings of the study it is concluded that the behavior regarding the risk estimation of SCORE and AHA 2013 scales is not concordant; therefore, their estimates are not interchangeable, tending to overestimate or underestimate the risk. (Acta Med Colomb 2018; 43: 192-199).
Palavras-chave : study; concordance; risk; cardiovacular.