Validation of the IberScore model in a primary care population.

BACKGROUND: This study aimed to validate the IberScore cardiovascular risk model in a population attended in the primary care setting. METHODS: A cohort of patients with no history of cardiovascular disease visited in a primary care center during the years 2008 and/or 2009 and followed up until 2018 was selected. Cardiovascular risk was calculated with the IberScore formula for all the subjects of the cohort and the model was calibrated, graphically represented by risk deciles the proportion of expected events and proportion of observed events at 10-year follow-up, stratified by sex. The area under the ROC curve was calculated to assess the discrimination of the model. RESULTS: A total of 10,085 patients visited during the years 2008 and/or 2009 were included in the study. Men showed a mean 10-year risk of suffering a fatal or non-fatal cardiovascular events according to IberScore of 17.07% (SD 20.13), with a mean estimated vascular age of more than 4 years higher than the biological age; while women had a mean 10-year risk of 7.91% (SD 9.03), with an estimated vascular age of more than 2 years above the biological age. The area under the ROC curve showed a discrimination index of the model of 0.86 (95% CI 0.84-0.88) in men and 0.82 (95% CI 0.79-0.85) in women. CONCLUSION: IberScore model discriminates well in the population attended in primary care but the model overestimates the risk.

Utilidad clínica de un modelo predictivo de riesgo cardiovascular en trabajadores / Clinical usefulness of a predictive model of cardiovascular risk among workers

La identificación de sujetos con alto riesgo cardiovascular constituye un desafío en población laboral. El proyecto IberScore ha derivado una función predictiva para eventos cardiovasculares a partir de una cohorte de 774.404 trabajadores, sin enfermedad cardiovascular previa y con 10 años de seguimiento. Durante el seguimiento, se identificaron 3.762 primeros eventos cardiovasculares en la cohorte de derivación (6‰; varones 90,7%; media edad=46,9±9,19 años). En el grupo con eventos se observó una presencia importante de factores de riesgo cardiovascular en la evaluación basal (tabaquismo 63,2%; dislipemia 20,6%; hipertensión 21,8%; diabetes 7,9%). Los resultados sugieren la utilidad clínica de un sistema de predicción del riesgo cardiovascular desarrollado específicamente en población trabajadora española. En esta población se produce un número no desdeñable eventos y hay una importante presencia de factores de riesgo, que pueden pasar desapercibidos debido al peso de la edad en los sistemas predictivos desarrollados para la población general

Identification of subjects at high cardiovascular risk is a challenge among working population. The IberScore Project has calculated a predictive function for cardiovascular events from a cohort of 774,404 Spanish workers without prior cardiovascular diseases, and 10-year follow-up. At follow-up, 3,762 first cardiovascular events were identified in the cohort of derivation (6‰; 90.7% men; mean age=46.9±9.19 years-old). In the group with events, it was observed a relevant presence of cardiovascular risk factors at baseline assessment (smoking 63.2%; dyslipidaemia 20.6%; hypertension 21.8%; diabetes 7.9%). The results suggest the clinical usefulness of a system to predict cardiovascular risk among specifically developed in Spanish working population. Among such population a significant number of events take place and there is a relevant presence of risk factors, which may go unnoticed due to the weight that age has in the predictive systems developed for the general population