Original and REGICOR Framingham Functions in a Nondiabetic Population of a Spanish Health Care Center: A Validation Study

Buitrago, Francisco; Calvo-Hueros, Juan Ignacio; Cañón-Barroso, Lourdes; Pozuelos-Estrada, Gerónimo; Molina-Martínez, Luis M.; Espigares-Arroyo, Manuel; Galán-González, Juan Antonio; Lillo-Bravo, Francisco J.

doi:10.1370/afm.1287

Cited by 9 publications

(6 citation statements)

References 46 publications

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“…In order to correlate the CV-ZS with other validated cardiovascular risk scores, the Framingham and REGICOR (for Spanish population) scores were estimated according to the equation described by Wilson P.W. et al 57 and through the online calculator available at www.imim.cat/ofertadeserveis/software-public/regicor/?1 58 , respectively. Both scores include age, sex-adjusted cardiovascular risk variables (total cholesterol, HDL-C and SBP and DBP), and presence of diabetes and tobacco consumption (both variables collected using a questionnaire).…”

Section: Study Populationmentioning

confidence: 99%

Circulating Undercarboxylated Osteocalcin as Estimator of Cardiovascular and Type 2 Diabetes Risk in Metabolic Syndrome Patients

Riquelme-Gallego

García-Molina

Cano-Ibáñez

et al. 2020

Sci Rep

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Undercarboxylated osteocalcin (ucoc) could be a biomarker of glucose disturbances and cardiovascular risk. our study aimed to determine the association between serum levels of ucoc and cardiovascular risk in metabolic syndrome (MetS) patients and to analyse its potential role as estimator of type 2 diabetes (T2D) risk in this population. This cross-sectional study included 235 patients with MetS, 53.2% women, aged 55-75 years. Circulating ucOC levels were measured by ELISA. Cardiovascular risk was determined as Z-score of the diagnostic criteria for MetS (CV-ZS). Linear regression model was performed to analyse the association between circulating ucoc and cV-ZS. A receiver operating curve (ROC) was performed to analyse the usefulness of ucOC as T2D risk estimator. Patients above the CV-ZS median showed significant lower ucOC levels. We found an inverse association between ucOC levels and CV-ZS in MetS patients without T2D. Patients with ucOC levels below the 25 th percentile showed worse cardiometabolic profile and higher cardiovascular and T2D risk. The area under the curve performed better when ucOC levels were included along with the classic T2D risk factors. The measurement of circulating ucOC could be a useful tool to identify increased cardiovascular and T2D risk in MetS patients without T2D. Current lifestyle is causing a remarkable increase in overweight up to epidemic numbers globally 1. In Spain, over 60% of the adult population is overweight or obese 2. According to this trend, an increase of 16% in the number of cases is estimated by 2030 associated with a 58% increase in direct healthcare costs 3. A large body of evidence has shown that all-cause mortality, and especially cardiovascular-related mortality, is associated with an increased central adiposity and overweight 4. Visceral obesity in conjunction with other disorders, such as dyslipidaemia, hypertension and fasting hyperglycaemia lead to the metabolic syndrome (MetS), conferring thus a larger risk of developing cardiovascular disease (CVD) 5. An association between osteoporosis, CVD and cardiovascular-related mortality has been reported 6,7. The common risk factors involved in bone fragility and CVD could partially explain this association. Therefore, the

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Section: Study Populationmentioning

confidence: 99%

Circulating Undercarboxylated Osteocalcin as Estimator of Cardiovascular and Type 2 Diabetes Risk in Metabolic Syndrome Patients

Riquelme-Gallego

García-Molina

Cano-Ibáñez

et al. 2020

Sci Rep

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“…analyzed the 10-year performance of the original Framingham coronary risk functions in nondiabetic patients. 37 They reported the observed (PO,t=10=0.109) and predicted (PE,t=10=0.169) 10-year risk estimates in a table, as well as the total number of observed events (Ot=10=22). Hence, we have with …”

Section: Data Extraction and Estimating Unreported Results To Facilitate Meta-analysismentioning

confidence: 99%

A framework for meta-analysis of prediction model studies with binary and time-to-event outcomes

Debray

Damen

Riley

et al. 2018

Stat Methods Med Res

156

154

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It is widely recommended that any developed-diagnostic or prognostic-prediction model is externally validated in terms of its predictive performance measured by calibration and discrimination. When multiple validations have been performed, a systematic review followed by a formal meta-analysis helps to summarize overall performance across multiple settings, and reveals under which circumstances the model performs suboptimal (alternative poorer) and may need adjustment. We discuss how to undertake meta-analysis of the performance of prediction models with either a binary or a time-to-event outcome. We address how to deal with incomplete availability of study-specific results (performance estimates and their precision), and how to produce summary estimates of the c-statistic, the observed:expected ratio and the calibration slope. Furthermore, we discuss the implementation of frequentist and Bayesian meta-analysis methods, and propose novel empirically-based prior distributions to improve estimation of between-study heterogeneity in small samples. Finally, we illustrate all methods using two examples: meta-analysis of the predictive performance of EuroSCORE II and of the Framingham Risk Score. All examples and meta-analysis models have been implemented in our newly developed R package "metamisc".

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“…[32][33][34] Moreover current most study's findings explain the rise of cardiovascular diseases risk factors in rural communities. 35 The study findings showed a minimal or fair level of agreement of 0.25 between FGRS and WHO/ISH score chart which is not acceptable in models prediction agreement by Cohen kappa due to models lack of discrimination capacity to fulfil the accuracy requirement of a test, a classifier or a model that requires the interrater reliability coefficient to be perfect at least 0.8 for the accurate agreement between used two models (FGRS and WHO/ISH score chart) to be both applied in Rwandan population. FGRS predicted 25.5% of the population to have elevated cardiovascular diseases absolute risk in coming 10 years (≥10%) while WHO/ISH score chart predicted only 4.6% of the population to have elevated risk of (≥10%) with a high predictable difference of 20.9% risk which underlined a suspect of under prediction of WHO/ISH score chart and Over prediction of FGRS.…”

Section: Discussionmentioning

confidence: 99%

Risk prediction of cardiovascular diseases and comparison of two prediction models

Nsanzabera

Sagwe

Ndengo

2020

Int J Community Med Public Health

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Background: Cardiovascular diseases (CVD) are the world leading causes of death in non-communicable diseases. The aim of this study is to predict cardiovascular risk and compare two prediction models.Methods: This cross-sectional study involved 440 sample size of beverage industrial participants. The 10-year prediction was processed by World Health Organization/International Society of Hypertension (WHO/ISH) score chart and Framingham general risk score. WHO stepwise questionnaire and biomedical forms was used. Data was collected and analyzed by SPSS 16.0 version.Results: The overall CVD low risk prediction (<10%) by Framingham general risk score (FGRS) and WHO/ISH score chart was 74.5%, 95.4%, respectively while the CVD elevated risk (≥10%) was 25.5%, 4.6%, respectively. Gender CVD risk (≥10%) was 16.1% of male versus 9.3% of female by FGRS while 2.7% of male versus 1.5% of female classified by WHO/ISH. CVD risk increases in both of the models with age but very much in FGRS. 8.4% of employees versus 5.2% of spouses was classified as having the risk of 10-20% by FGRS while WHO/ISH classified 2.5% of employees and 0.9% of spouses as having the risk of 10-20%. FGRS classified 11.7% of all participant as having the risk above 20% while WHO/ISH classified only 1% as having the risk above 20%. Two model’s kappa agreement level was fair or minimal interrater reliability with 0.25 with p value <0.001 and the correlated receiver operating characteristic curve (ROC) curve of FGRS and WHO/ISH of 0.887 area under the curve (AUC), 0.847AUC all with a p value <0.001, respectively.Conclusions: FGRS predicted more risk in participants than WHO/ISH and was with minimal kappa agreement.

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Original and REGICOR Framingham Functions in a Nondiabetic Population of a Spanish Health Care Center: A Validation Study

Cited by 9 publications

References 46 publications

Circulating Undercarboxylated Osteocalcin as Estimator of Cardiovascular and Type 2 Diabetes Risk in Metabolic Syndrome Patients

Circulating Undercarboxylated Osteocalcin as Estimator of Cardiovascular and Type 2 Diabetes Risk in Metabolic Syndrome Patients

A framework for meta-analysis of prediction model studies with binary and time-to-event outcomes

Risk prediction of cardiovascular diseases and comparison of two prediction models

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