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A consultation-based method is equal to SCORE and an extensive laboratory-based method in predicting risk of future cardiovascular disease.

Petersson, Ulla LU ; Östgren, Carl Johan LU ; Brudin, Lars and Nilsson, Peter LU (2009) In European Journal of Cardiovascular Prevention & Rehabilitation 16. p.536-540
Abstract
BACKGROUND: As cardiovascular disease (CVD) is one of the most common causes of mortality worldwide, much interest has been focused on reliable methods to predict cardiovascular risk. DESIGN: A cross-sectional, population-based screening study with 17-year follow-up in Southern Sweden. METHODS: We compared a non-laboratory, consultation-based risk assessment method comprising age, sex, present smoking, prevalent diabetes or hypertension at baseline, blood pressure (systolic >/=140 or diastolic >/=90), waist/height ratio and family history of CVD to Systemic COronary Risk Evaluation (SCORE) and a third model including several laboratory analyses, respectively, in predicting CVD risk. The study included clinical baseline data on 689... (More)
BACKGROUND: As cardiovascular disease (CVD) is one of the most common causes of mortality worldwide, much interest has been focused on reliable methods to predict cardiovascular risk. DESIGN: A cross-sectional, population-based screening study with 17-year follow-up in Southern Sweden. METHODS: We compared a non-laboratory, consultation-based risk assessment method comprising age, sex, present smoking, prevalent diabetes or hypertension at baseline, blood pressure (systolic >/=140 or diastolic >/=90), waist/height ratio and family history of CVD to Systemic COronary Risk Evaluation (SCORE) and a third model including several laboratory analyses, respectively, in predicting CVD risk. The study included clinical baseline data on 689 participants aged 40-59 years without CVD. Blood samples were analyzed for blood glucose, serum lipids, insulin, insulin-like growth factor-I, insulin-like growth factor binding protein-1, C-reactive protein, asymmetric dimethyl arginine and symmetric dimethyl arginine. During 17 years, the incidence of total CVD (first event) and death was registered. RESULTS: A non-laboratory-based risk assessment model, including variables easily obtained during one consultation visit to a general practitioner, predicted cardiovascular events as accurately [hazard ratio (HR): 2.72; 95% confidence interval (CI): 2.18-3.39, P<0.001] as the established SCORE algorithm (HR: 2.73; 95% CI: 2.10-3.55, P<0.001), which requires laboratory testing. Furthermore, adding a combination of sophisticated laboratory measurements covering lipids, inflammation and endothelial dysfunction, did not confer any additional value to the prediction of CVD risk (HR: 2.72; 95% CI: 2.19-3.37, P<0.001). The c-statistics for the consultation model (0.794; 95% CI: 0.762-0.823) was not significantly different from SCORE (0.767; 95% CI: 0.733-0.798, P=0.12) or the extended model (0.806; 95% CI: 0.774-0.835, P=0.55). CONCLUSION: A risk algorithm based on non-laboratory data from a single primary care consultation predicted long-term cardiovascular risk as accurately as either SCORE or an elaborate laboratory-based method in a defined middle-aged population. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
European Journal of Cardiovascular Prevention & Rehabilitation
volume
16
pages
536 - 540
publisher
Lippincott Williams & Wilkins
external identifiers
  • wos:000271456200003
  • pmid:19357517
  • scopus:72449183200
ISSN
1741-8275
DOI
10.1097/HJR.0b013e32832b1833
language
English
LU publication?
yes
id
780ed7ed-740c-4d37-8ac0-560fc7767ebb (old id 1392225)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19357517?dopt=Abstract
date added to LUP
2009-05-06 14:28:11
date last changed
2017-05-28 04:31:30
@article{780ed7ed-740c-4d37-8ac0-560fc7767ebb,
  abstract     = {BACKGROUND: As cardiovascular disease (CVD) is one of the most common causes of mortality worldwide, much interest has been focused on reliable methods to predict cardiovascular risk. DESIGN: A cross-sectional, population-based screening study with 17-year follow-up in Southern Sweden. METHODS: We compared a non-laboratory, consultation-based risk assessment method comprising age, sex, present smoking, prevalent diabetes or hypertension at baseline, blood pressure (systolic &gt;/=140 or diastolic &gt;/=90), waist/height ratio and family history of CVD to Systemic COronary Risk Evaluation (SCORE) and a third model including several laboratory analyses, respectively, in predicting CVD risk. The study included clinical baseline data on 689 participants aged 40-59 years without CVD. Blood samples were analyzed for blood glucose, serum lipids, insulin, insulin-like growth factor-I, insulin-like growth factor binding protein-1, C-reactive protein, asymmetric dimethyl arginine and symmetric dimethyl arginine. During 17 years, the incidence of total CVD (first event) and death was registered. RESULTS: A non-laboratory-based risk assessment model, including variables easily obtained during one consultation visit to a general practitioner, predicted cardiovascular events as accurately [hazard ratio (HR): 2.72; 95% confidence interval (CI): 2.18-3.39, P&lt;0.001] as the established SCORE algorithm (HR: 2.73; 95% CI: 2.10-3.55, P&lt;0.001), which requires laboratory testing. Furthermore, adding a combination of sophisticated laboratory measurements covering lipids, inflammation and endothelial dysfunction, did not confer any additional value to the prediction of CVD risk (HR: 2.72; 95% CI: 2.19-3.37, P&lt;0.001). The c-statistics for the consultation model (0.794; 95% CI: 0.762-0.823) was not significantly different from SCORE (0.767; 95% CI: 0.733-0.798, P=0.12) or the extended model (0.806; 95% CI: 0.774-0.835, P=0.55). CONCLUSION: A risk algorithm based on non-laboratory data from a single primary care consultation predicted long-term cardiovascular risk as accurately as either SCORE or an elaborate laboratory-based method in a defined middle-aged population.},
  author       = {Petersson, Ulla and Östgren, Carl Johan and Brudin, Lars and Nilsson, Peter},
  issn         = {1741-8275},
  language     = {eng},
  pages        = {536--540},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {European Journal of Cardiovascular Prevention & Rehabilitation},
  title        = {A consultation-based method is equal to SCORE and an extensive laboratory-based method in predicting risk of future cardiovascular disease.},
  url          = {http://dx.doi.org/10.1097/HJR.0b013e32832b1833},
  volume       = {16},
  year         = {2009},
}