The REGICOR-calibrated function provides a better classification of high-risk patients on statin treatment in the Spanish population than the Framingham or SCORE classifications.

INTRODUCTION AND OBJECTIVES: To determine which cardiovascular risk function is best for classifying high-risk individuals on statins. METHODS: Descriptive cross-sectional study of 804 randomly selected patients aged 35-74 years. Variables studied included statin treatment, high cardiovascular risk according to Framingham-REGICOR (10-year risk >or=10%), Framingham-Wilson (10-year risk >or=20%) and SCORE (10-year risk >or=5%) functions, age, sex, cardiovascular risk factors, and total and high-density lipoprotein (HDL) cholesterol. RESULTS: Overall, 83 patients (10.3%) were taking statins. The prevalence of hypercholesterolemia was 25.6%. When high-risk patients were compared with low- and medium-risk patients, the SCORE function only found a significant difference in HDL-cholesterol level (difference, 5.1 mg/dl; P< .001), whereas the Framingham-REGICOR and Framingham-Wilson functions showed that hypercholesterolemia was more prevalent (at 41% and 37.8%, respectively), the total cholesterol level was higher (difference, 15 mg/dl and 12.5 mg/dl, respectively), and the HDL-cholesterol level was lower (difference, 11.9 mg/ dl and 12 mg/dl, respectively; all P< .001). The percentage of patients on statins classified as high-risk by each function was 16% for Framingham-REGICOR (odds ratio [OR]=1.81; 95% confidence interval [CI], 1.01-3.27), 13.4% for Framingham-Wilson (OR=1.47; 95% CI, 0.87-2.47) and 10.6% for SCORE (OR=1.09; 95% CI, 0.50-2.37). Statin use was also significantly associated with hypertension (OR=1.89; 95% CI, 1.20-2.99) and hypercholesterolemia (OR=11.01; 95% CI, 6.55-18.53), and inversely associated with age in patients <65 years (OR=0.51; 95% CI, 0.32-0.81). CONCLUSIONS: The Framingham-REGICOR function was better at classifying high-risk patients on statins than the Framingham-Wilson or SCORE functions. Statin use was associated with hypercholesterolemia and hypertension and inversely with age in patients <65 years.

La función calibrada REGICOR mejora la clasificación de los pacientes de alto riesgo tratados con estatinas respecto a Framingham y SCORE en la población española / The REGICOR-calibrated function provides a better classification of high-risk patients on statin treatment in the Spanish population than the Framingham or SCORE classifications

Introducción y objetivos. Estudiar qué función de riesgo cardiovascular clasifica mejor a los pacientes con riesgo cardiovascular alto que toman estatinas. Métodos. Estudio descriptivo transversal que incluye a 804 pacientes de 35-74 años, seleccionados aleatoriamente. Se estudiaron las variables tratamiento con estatinas, riesgo cardiovascular alto con las ecuaciones de Framingham-REGICOR (≥ 10% a 10 años), Framingham-Wilson (≥ 20% a 10 años) y SCORE (≥ 5% a 10 años), edad, sexo, colesterol total, colesterol de las lipoproteínas de alta densidad (cHDL) y factores de riesgo cardiovascular. Resultados. Tomaban estatinas 83 (10,3%) pacientes. La prevalencia de hipercolesterolemia fue del 25,6%. Comparando a los pacientes de bajo y medio riesgo con los de alto riesgo, SCORE sólo halló diferencias significativas en el cHDL más bajo (diferencia: 5,1 mg/dl; p < 0,001), mientras que Framingham-REGICOR y Framingham-Wilson mostraron (p < 0,001) mayor prevalencia de hipercolesterolemia (el 41 y el 37,8% respectivamente), colesterol total más elevado (diferencia, 15 y 12,5 mg/dl respectivamente) y cHDL más bajo (diferencia, 11,9 y 12 mg/dl respectivamente). Tomaba estatinas el 16% de pacientes de alto riesgo con Framingham-REGICOR (odds ratio [OR] = 1,81; intervalo de confianza [IC] del 95%, 1,01-3,27), el 13,4% con Framingham-Wilson (OR = 1,47; IC del 95%, 0,87-2,47) y el 10,6% con SCORE (OR = 1,09; IC del 95%, 0,50-2,37). Se asociaron significativamente al uso de estatinas la hipertensión (OR = 1,89; IC del 95%, 1,20-2,99) y la hipercolesterolemia (OR = 11,01; IC del 95%, 6,55-18,53), con una relación inversa con la edad < 65 años (OR = 0,51; IC del 95%, 0,32-0,81). Conclusiones. La función Framingham-REGICOR clasifica mejor que Framingham-Wilson y SCORE a los pacientes de riesgo alto que reciben tratamiento con estatinas. La prescripción se asoció al diagnóstico de hipercolesterolemia y HTA y fue menor en pacientes < 65 años (AU)

Introduction and objectives. To determine which cardiovascular risk function is best for classifying high-risk individuals on statins. Methods. Descriptive cross-sectional study of 804 randomly selected patients aged 35-74 years. Variables studied included statin treatment, high cardiovascular risk according to Framingham-REGICOR (10-year risk ≥10%), Framingham-Wilson (10-year risk ≥20%) and SCORE (10-year risk ≥5%) functions, age, sex, cardiovascular risk factors, and total and high-density lipoprotein (HDL) cholesterol. Results. Overall, 83 patients (10.3%) were taking statins. The prevalence of hypercholesterolemia was 25.6%. When high-risk patients were compared with low- and medium-risk patients, the SCORE function only found a significant difference in HDL-cholesterol level (difference, 5.1 mg/dl; P < .001), whereas the Framingham-REGICOR and Framingham-Wilson functions showed that hypercholesterolemia was more prevalent (at 41% and 37.8%, respectively), the total cholesterol level was higher (difference, 15 mg/dl and 12.5 mg/dl, respectively), and the HDL-cholesterol level was lower (difference, 11.9 mg/ dl and 12 mg/dl, respectively; all P < .001). The percentage of patients on statins classified as high-risk by each function was 16% for Framingham-REGICOR (odds ratio [OR]=1.81; 95% confidence interval [CI], 1.01-3.27), 13.4% for Framingham-Wilson (OR=1.47; 95% CI, 0.87-2.47) and 10.6% for SCORE (OR=1.09; 95% CI, 0.50-2.37). Statin use was also significantly associated with hypertension (OR=1.89; 95% CI, 1.20-2.99) and hypercholesterolemia (OR=11.01; 95% CI, 6.55-18.53), and inversely associated with age in patients <65 years or 95 ci 0 32-0 81 conclusions the framingham-regicor function was better at classifying high-risk patients on statins than framingham-wilson score functions statin use associated with hypercholesterolemia and hypertension inversely age in <65 years (AU)

Comparación de los modelos SCORE y REGICOR para el cálculo del riesgo cardiovascular en sujetos sin enfermedad cardiovascular atendidos en un centro de salud de Barcelona / Comparison of the SCORE and REGICOR Models for Calculating Cardiovascular Risk in Cardiovascular Disease-Free Individuals at a Healthcare Center in Barcelona, Spain

Fundamento: No se dispone de estudios que hayan comparadoSCORE, REGICOR y Framingham. El objetivo de este trabajo esestudiar cómo clasifican el riesgo cardiovascular las funcionesREGICOR y SCORE, su correlación y concordancia respecto a Framingham(1998) y si presentan diferencias respecto a los factores deriesgo cardiovascular en los casos de riesgo alto.Métodos: Estudio descriptivo transversal realizado en atención primaria.Se incluyó a 851 personas entre 35-74 años, libres de enfermedadescardiovasculares y seleccionadas por muestreo aleatorio simple.Se estudió la proporción de pacientes de riesgo alto con Framingham(³20% a 10 años), SCORE (³5% a 10 años) y REGICOR con puntos decorte ³20%, ³15%, ³10% y ³5% a 10 años, ya que con REGICOR³20% apenas hay casos con riesgo alto. Se comparó la correlación (r dePearson) y concordancia (coeficiente Kappa) de las personas de riesgoalto de REGICOR y SCORE respecto a Framingham.Resultados: Presentaron riesgo alto 23,3% con Framingham,15,2% con SCORE y un 1,4%, 5,8%, 17,6% y 57,0% con REGICORcon los puntos de corte descritos, respectivamente. REGICOR tuvouna correlación de 0,99 y SCORE de 0,78. REGICOR ³10% tuvomejor concordancia (Kappa 0,83) que SCORE (Kappa 0,61). Alcomparar los factores de riesgo cardiovascular de los casos con riesgoalto (³20% Framingham, ³5% SCORE y ³10% REGICOR), elsegundo presentó mayor prevalencia de diabetes y menor de hipercolesterolemia(p<0,05).Conclusiones: REGICOR presentó una buena correlación conFramingham. Con el punto de corte ³10% clasifica como riesgo altoa un número de personas similar a SCORE e inferior a Framingham.El modelo SCORE trataría con hipolipemiantes a un número parecidode pacientes que el modelo REGICOR ³10%, pero con menorevidencia de efectividad del tratamiento

Background: No studies have been published to date comparingSCORE, REGICOR and Framingham models. This study isaimed at analyzing how the REGICOR and SCORE functions classifycardiovascular risk, their correlation and concordance withFramingham (1998) and whether any differences exist among themwith regard to the cardiovascular risk factors in high-risk groups.Methods: Descriptive cross-sectional study conducted in primarycare. A total of 851 individuals within the 35-74 age range, freeof cardiovascular diseases and selected by simple random samplingwere included. A study was made of the percentage of high-riskpatients with Framingham (³20% ten-year risk), SCORE (³5% tenyearrisk) and REGICOR with cutoff points ³20%, ³15%, ³10% and³5% at 10 years, given that with REGICOR ³20% there are hardlyany high-risk cases. A comparison was drawn between the correlation(Pearson´s r) and concordance (Kappa index) of the REGICORand SCORE high-risk individuals as compared to Framingham.Results: The high-risk percentages respectively found were:23.3% with Framingham; 15.2%; with SCORE; and 1.4%, 5.8%,17.6% and 57.0% with REGICOR with the cutoff points described.REGICOR has a 0.99 correlation, SCORE a 0.78 correlation. REGICOR³10% showed a better concordance (Kappa 0.83) than SCORE(Kappa 0.61). On comparing the cardiovascular risk factors of thehigh-risk cases (³20% Framingham, ³5% SCORE and ³10% REGICOR),SCORE showed higher prevalence of diabetes and a lowerprevalence of hypercholesterolemia (p<0.05).Conclusions: REGICOR showed a good correlation with Framingham.With the ³10% cutoff point, it classifies a number of individualsas high-risk similar to SCORE and fewer than Framingham.The SCORE model would treat a number of patients similar to theREGICOR ³10% model with hypolipemiant drugs, however showinglesser evidence of effectiveness of the treatment

[Comparison of the SCORE and REGICOR models for calculating cardiovascular risk in cardiovascular disease-free individuals at a healthcare center in Barcelona, Spain]. / Comparación de los modelos SCORE y REGICOR para el cálculo del riesgo cardiovascular en sujetos sin enfermedad cardiovascular atendidos en un centro de salud de Barcelona.

BACKGROUND: No studies have been published to date comparing SCORE, REGICOR and Framingham models. This study is aimed at analyzing how the REGICOR and SCORE functions classify cardiovascular risk, their correlation and concordance with Framingham (1998) and whether any differences exist among them with regard to the cardiovascular risk factors in high-risk groups. METHODS: Descriptive cross-sectional study conducted in primary care. A total of 851 individuals within the 35-74 age range, free of cardiovascular diseases and selected by simple random sampling were included. A study was made of the percentage of high-risk patients with Framingham (> or = 20% ten-year risk), SCORE (> or = 5% ten-year risk) and REGICOR with cutoff points > or = 20%, > or = 15%, > or = 10% and > or = 5% at 10 years, given that with REGICOR > or = 20% there are hardly any high-risk cases. A comparison was drawn between the correlation (Pearson's r) and concordance (Kappa index) of the REGICOR and SCORE high-risk individuals as compared to Framingham. RESULTS: The high-risk percentages respectively found were: 23.3% with Framingham; 15.2%; with SCORE; and 1.4%, 5.8%, 17.6% and 57.0% with REGICOR with the cutoff points described. REGICOR has a 0.99 correlation, SCORE a 0.78 correlation. REGICOR > or = 10% showed a better concordance (Kappa 0.83) than SCORE (Kappa 0.61). On comparing the cardiovascular risk factors of the high-risk cases (> or = 20% Framingham, > or = 5% SCORE and > or = 10% REGICOR), SCORE showed higher prevalence of diabetes and a lower prevalence of hypercholesterolemia (p<0.05). CONCLUSIONS: REGICOR showed a good correlation with Framingham. With the > or = 10% cutoff point, it classifies a number of individuals as high-risk similar to SCORE and fewer than Framingham. The SCORE model would treat a number of patients similar to the REGICOR > or =10% model with hypolipemiant drugs, however showing lesser evidence of effectiveness of the treatment.

Impacto de la revisión de los criterios de la ADA-2003 sobre la prevalencia de la glucemia basal alterada / Impact of 2003 ADA´s criteria revision on the prevalence of impaired fasting glucose

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