Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2015;68:205-15 - Vol. 68 Num.03 DOI: 10.1016/j.rec.2014.03.019

The ERICE-score: the New Native Cardiovascular Score for the Low-risk and Aged Mediterranean Population of Spain

Rafael Gabriel a,b,, Carlos Brotons b,c, M. José Tormo d,e,f, Antonio Segura g, Fernando Rigo h,i, Roberto Elosua f,j, Julio A. Carbayo k, Diana Gavrila d,e,f, Irene Moral c, Jaakko Tuomilehto a,b,l, Javier Muñiz a,b,m, on behalf of the ERICE study group

a Unidad de Epidemiología Clínica, Instituto IdiPAZ, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, Spain
b Red de Investigación Cardiovascular (RIC), Spain
c Unidad de Investigación, EAP Sardenya-IIB Sant Pau, Barcelona, Spain
d Servicio de Epidemiología, Conserjería de Sanidad de Murcia, Murcia, Spain
e Departamento de Ciencias Sociosanitarias, Universidad de Murcia, Murcia, Spain
f CIBER Epidemiología y Salud Pública, CIBERESP, Spain
g Instituto de Ciencias de la Salud de Castilla-La Mancha, Talavera de la Reina, Toledo, Spain
h Grupo CORSAIB, IB-Salut, Palma de Mallorca, Islas Baleares, Spain
i Red de Investigación en Actividades Preventivas y Promoción de la Salud (redIAPP), Spain
j Epidemiología Cardiovascular y Genética, IMIM (Instituto de Investigación Hospital del Mar), Barcelona, Spain
k Unidad de Lípidos, Clínica Nuestra Señora del Rosario, Grupo de Enfermedades Vasculares de Albacete (GEVA), Albacete, Spain
l University of Helsinki, Helsinki, Finland
m Instituto Universitario de Ciencias de la Salud, Universidad de A Coruña, A Coruña, Spain

Keywords

Risk score. Low-cardiovascular risk. Aging. Mediterranean. Diabetes mellitus. Spain.

Abstract

Introduction and objectives

In Spain, data based on large population-based cohorts adequate to provide an accurate prediction of cardiovascular risk have been scarce. Thus, calibration of the EuroSCORE and Framingham scores has been proposed and done for our population. The aim was to develop a native risk prediction score to accurately estimate the individual cardiovascular risk in the Spanish population.

Methods

Seven Spanish population-based cohorts including middle-aged and elderly participants were assembled. There were 11 800 people (6387 women) representing 107 915 person-years of follow-up. A total of 1214 cardiovascular events were identified, of which 633 were fatal. Cox regression analyses were conducted to examine the contributions of the different variables to the 10-year total cardiovascular risk.

Results

Age was the strongest cardiovascular risk factor. High systolic blood pressure, diabetes mellitus and smoking were strong predictive factors. The contribution of serum total cholesterol was small. Antihypertensive treatment also had a significant impact on cardiovascular risk, greater in men than in women. The model showed a good discriminative power (C-statistic = 0.789 in men and C = 0.816 in women). Ten-year risk estimations are displayed graphically in risk charts separately for men and women.

Conclusions

The ERICE is a new native cardiovascular risk score for the Spanish population derived from the background and contemporaneous risk of several Spanish cohorts. The ERICE score offers the direct and reliable estimation of total cardiovascular risk, taking in consideration the effect of diabetes mellitus and cardiovascular risk factor management. The ERICE score is a practical and useful tool for clinicians to estimate the total individual cardiovascular risk in Spain.

1885-5857/© 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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