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

Abstract

Introduction and objectivesIn 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. Resumen Introducción y objetivosEn España no existen unas cohortes poblacionales suficientemente grandes para hacer predicciones precisas del riesgo cardiovascular. Las ecuaciones de Framingham y EuroSCORE calibradas son las más utilizadas en España. El objetivo es desarrollar la primera ecuación de predicción autóctona para estimar con precisión el riesgo cardiovascular individual en España. Métodos Análisis conjunto de siete cohortes españolas de población de mediana edad y anciana. La población del estudio -11.800 personas (6.387 mujeres)-aportó un total de 107.915 personas-año de seguimiento y 1.214 eventos cardiovasculares (633 de ellos, mortales). Se efectuó un análisis de regresión de Cox para examinar la contribución de los diferentes factores al riesgo de cualquier evento cardiovascular (mortal y no mortal). Resultados La edad fue el principal factor de riesgo de eventos cardiovasculares. La presión arterial sistólica, la diabetes mellitus, el tabaquismo y el tratamiento antihipertensivo fueron factores predictivos fuertemente asociados con el riesgo cardiovascular. En cambio, la contribución del colesterol total sérico fue pequeña, especialmente en los mayores de 70 años. El modelo final de riesgo mostró un buen...

Lipid profile, cardiovascular disease and mortality in a Mediterranean high-risk population: The ESCARVAL-RISK study

“…The relationship between lipid parameters and rates of cardiovascular risk has been explored previously in Spain, although these were performed in the 1990s. The ERICE [ 15 ] and the FRESCO [ 5 ] studies included data from 11 population cohorts in seven Spanish regions. The results of the FRESCO study were consistent with our finding that HDL-C was the lipid factor most strongly associated with cardiovascular risk.…”

Cardiometabolic risk prediction algorithms for young people with psychosis: a systematic review and exploratory analysis

“…The literature search returned 7744 results after removing duplicates. We reviewed 362 full texts, of which 110 studies met inclusion criteria (28‐30, 33‐138). See Fig.…”

Cardiovascular risk factors associated with acute myocardial infarction and stroke in the MADIABETES cohort

“…Another study in the T2DM Spanish population showed that the ratio of non–HDL-cholesterol to HDL-cholesterol was a significant predictor of cardiovascular events, whilst no significant associations were observed for LDL-cholesterol and total cholesterol 11 . Likewise, the ERICE score, a new native cardiovascular score for the low-risk, elderly Mediterranean population of Spain, claimed that the contribution of serum total cholesterol to coronary heart disease was small 20 .…”