Comparison of different cardiovascular risk score calculators for cardiovascular risk prediction and guideline recommended statin uses

Abstract

ObjectiveThe accuracy of various 10-year cardiovascular disease (CVD) risk calculators in Indians may not be the same as in other populations. Present study was conducted to compare the various calculators for CVD risk assessment and statin eligibility according to different guidelines.MethodsConsecutive 1110 patients who presented after their first myocardial infarction were included. Their CVD risk was calculated using Framingham Risk score- Coronary heart disease (FRS-CHD), Framingham Risk Score- Cardiovascular Disease (FRS-CVD), QRISK2, Joint British Society risk calculator 3 (JBS3), American College of Cardiology/American Heart Association (ACC/AHA), atherosclerotic cardiovascular disease (ASCVD) and WHO risk charts, assuming that they had presented one day before cardiac event for risk assessment. Eligibility for statin uses was also looked into using ACC/AHA, NICE and Canadian guidelines.ResultsFRS-CVD risk assessment model has performed the best as it could identify the highest number of patients (51.9%) to be at high CVD risk while WHO and ASCVD calculators have performed the worst (only 16.2% and 28.3% patients respectively were stratified into high CVD risk) considering 20% as cut off for high risk definition. QRISK2, JBS3 and FRS-CHD have performed intermediately. Using NICE, ACC/AHA and Canadian guidelines; 76%, 69% and 44.6% patients respectively were found to be eligible for statin use.ConclusionFRS-CVD appears to be the most useful for CVD risk assessment in Indians, but the difference may be because FRS-CVD estimates risk for several additional outcomes as compared with other risk scores. For statin eligibility, however, NICE guideline use is the most appropriate.

Predicted 10-year risk of cardiovascular disease in the Islamic Republic of Iran and the body mass index paradox

“…The risks calculated in the study are based on the Framingham model, which was assumed to be applicable to the Islamic Republic of Iran. However, the Framingham risk score has been reported to be the most useful risk assessment tool in Asian countries such as India (36). As ours was a cross-sectional study, the associations found between the variables examined and CVD cannot be considered causal.…”

The clinical characterization of the adult patient with depression aimed at personalization of management

“…Patients with high risk for cardiovascular disease can be identified by one of several "cardiovascular risk calculators", including the WHO cardiovascular risk prediction charts, the Joint British Societies risk calculator (JBS3), and the Framingham risk score (FRS-CVD), some of which are available online [182][183][184] . The WHO risk prediction charts, for example, quantify the 10-year risk of a fatal or non-fatal major cardiovascular event (i.e., myocardial infarction or stroke), according to age, gender, blood pressure, smoking status, total cholesterol and presence or absence of diabetes mellitus 183 .…”

Effects on Cardiovascular Risk Scores and Vascular Age After Aerobic Exercise and Nutritional Intervention in Sedentary and Overweight/Obese Adults with Primary Hypertension: The EXERDIET-HTA Randomized Trial Study

“…Hence, it could be considered that the ASCVD-CVR score calculator by the American College of Cardiology and the American Heart Association would identify the least number of participants with CVR (i.e., underestimation), or the FRS-CVR would stratify a maximum number of individuals with high CVR (i.e., overestimation) [6]. This difference could likely be caused by the objective of each score; the FRS estimates CVR for a large combination of CVD outcomes and the ASCVD tool estimates risk mainly for myocardial infarction (fatal and nonfatal) and stroke only [25] and does not consider family history, which influences mortality [25].…”