Estimación del riesgo coronario en España mediante la ecuación de Framingham calibrada

Abstract

Introduction and objectives. The Framingham coronary heart disease (CHD) functions overestimate the risk of CHD in countries with a low incidence. Consequently, these functions should be calibrated for the purpose of primary prevention. Calibrated Framingham function charts of overall CHD risk for the Spanish population are presented. Patients and methods. The Framingham functions were calibrated by substituting the prevalence of CHD risk factors and incidence found in Framingham with the same values for Spain. The Framingham function that included high-density lipoprotein (HDL) cholesterol was used. The 10-year probability of developing a CHD event was estimated for several combinations of risk factors and HDL levels ranging from 35 to 59 mg/dl. Color-coded charts were prepared that show the exact probability of CHD corresponding to each combination of risk factors, shown in separate cells on the chart. Results. The event rate and prevalence of CHD risk factors differed considerably between Girona and Framingham. HDL < 35 mg/dL increased risk by approximately 50% and HDL > 60 mg/dL reduced it by 50%. The proportion of cells in which the 10-year probability of developing a CHD event was > 9% was 2.3 times higher and that of cells with a probability > 19% was 13 times lower in the chart calibrated for Spain than in the original Framingham charts. Conclusions. The calibrated Framingham function may help to more accurately estimate the overall risk of CHD in the Spanish population for primary prevention purposes. The calibrated function should be validated, and the development of functions for the Spanish population should be promoted.

Coronary Artery Calcification in the Asian Population: An Overview of the Results from the Korea Initiatives on Coronary Artery Calcification Registry

“…To this end, several previous studies have examined multiple ethnic or racial groups in an effort to test the utility or validity of the FRS. Several investigators have demonstrated the overestimation of cardiovascular risk when FRS was directly applied to other ethnicities, such as in Asia including South Korea and several countries in Europe [17][18][19][20][21][22]. In a study based on a Korean population, the investigators reported that FRS overestimated CAD risk and CAD incidence was low [18].…”

Validity of an adaptation of the Framingham cardiovascular risk function: the VERIFICA study

“…The risk functions used in this study include the Framingham function 17 and the REGICOR adaptation to the risk factor prevalence and event characteristics of the population in Spain. 15 …”

Cardiovascular risk estimated after 13 years of follow-up in a low-incidence Mediterranean region with high-prevalence of cardiovascular risk factors

“…Obtaining such indicators requires knowing in anticipation both the prevalence of RF in the community and the associated relative risks, ideally coming from population-based prospective studies. From an individual perspective, however, charts of coronary risk are used to predict the chance of suffering a CV event within a certain period of time [8-10]. Those nowadays available in Spain, however, rely on risk estimates available for the USA (REGICOR) [8] or European (SCORE) [9] populations.…”

“…From an individual perspective, however, charts of coronary risk are used to predict the chance of suffering a CV event within a certain period of time [8-10]. Those nowadays available in Spain, however, rely on risk estimates available for the USA (REGICOR) [8] or European (SCORE) [9] populations. Both, REGICOR and SCORE are calibrations of the Framingham and SCORE risk functions, respectively, but only the first has been validated for use in Spain [11].…”