Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2011;64:385-94 - Vol. 64 Num.05 DOI: 10.1016/j.rec.2010.12.017

Relative Validity of the 10-Year Cardiovascular Risk Estimate in a Population Cohort of the REGICOR Study

Jaume Marrugat a,, Joan Vila a, José Miguel Baena-Díez a,b,c, María Grau a, Joan Sala d, Rafel Ramos c,e,f, Isaac Subirana a,g, Montserrat Fitó a,h, Roberto Elosua a,g

a Grupo de Epidemiología y Genética Cardiovascular, Instituto Municipal de Investigación Médica, Barcelona, Spain
b Centro de Atención Primaria La Marina, Barcelona, Spain
c Fundació Jordi Gol i Gurina, Institut Català de la Salut, Barcelona, Spain
d Servicio de Cardiología, Hospital Universitari Josep Trueta, Institut Català de la Salut, Girona, Spain
e Facultat de Medicina, Universitat de Girona, Spain
f Unitat de Recerca d’Atenció Primària, Institut Català de la Salut, Girona, Spain
g CIBER Epidemiología y Salud Pública, Barcelona, Spain
h CIBER de Obesidad y Nutrición, Madrid, Spain

Keywords

Primary prevention. Cardiovascular diseases. Coronary disease. Risk function.

Abstract

Introduction and objectives

Cardiovascular risk screening requires accurate risk functions. The relative validity of the Framingham-based REGICOR adapted function is analyzed and the population distribution of cardiovascular 10-year cardiovascular events is described by risk group.

Methods

A population cohort of 3856 participants recruited between 1995 and 2000, aged 35 to 74years from Girona without symptoms of cardiovascular diseases, was followed between 2006 and 2009. Standardized laboratory and blood pressure measurements, questionnaires, and case definitions were used. The follow-up combined cross-linkage of our databases with our regional mortality registry, reexamination, and telephone contact with participants. Coronary disease endpoints alone were considered.

Results

A total of 27 487 person-years were obtained (mean follow-up 7.1years), and the follow-up was achieved in 97% of participants (120 coronary disease events). Validity was good: the regression coefficients estimated with the cohort data did not differ from those obtained in the original Framingham function. Function calibration was good: the observed incidence of cardiovascular events in the decile groups of risk did not differ from the function prediction (P=.127 in women, and P=.054 in men). The C statistic (discrimination) was 0.82 (95% confidence interval, 0.76-0.88) in women, and 0.78 (95% confidence interval, 0.73-0.83) in men. More than 50% of cardiovascular events occurred in participants whose 10-year risk was 5% to 14.9%.

Conclusions

The studied function accurately predicts coronary disease events at 10years. Risk stratification could be simplified in 4 groups: low (<5%), moderate (5%-9.9%), high (10%-14.9%) and very high (≥15%).

1885-5857/© 2011 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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