0013: Predictive accuracy of the ESC score in French general population

Abstract

The assessment of cardiovascular risk is uniformly recommended as a decision-support for therapies aimed at preventing cardiovascular diseases. The aim of this study was to assess the predictive accuracy of the ESC SCORE in French general population. Our analysis was based on the Third French MONICA Cross-sectional population-based survey (from South-Western(SW), North-Eastern(NE) and Northern(N) France), on cardiovascular risk factors (1995-1996) and on subjects consecutively referred for cardiovascular check-up to a Department of Preventive Cardiology (DPC) in a SW French University Hospital since 1995. Vital status was obtained 10 years after inclusion. The 10-year predicted risk of cardiovascular (CV) death was calculated using the SCORE equation for low-risk countries and was compared to the 10-year incidence of CV death. SCORE equation was applied in 6915 participants aged 35-64 (56% were men) and 56 CV deaths occurred. The CV death rate was 0.67% [95% confidence interval: 0.39-1.13] in DPC and 0.81%[0.42-1.56], 1.10%[0.61-1.98] and 2.00%[1.31-3.05] in SW, NE and N MONICA sample, respectively. The median risk SCORE was 0.97% and was not significantly different to the 10-year incidence of CV death (1.05%[0.81-1.37]). The C-statistic of the SCORE equation in our sample was 79%[73-85]. The median risk SCORE according to sex, age, educational level, family history of premature CV disease, physical activity, impaired fasting glucose, smoking, systolic blood pressure, total cholesterol, LDL-cholesterol, HDL-cholesterol and risk SCORE was not different to the 10-year incidence of CV death. According to the cut-point of 5%, 6440 participants(93%) were correctly classified using the SCORE equation (i.e. subjects with risk SCORE ?65; 5% deceased during the 10-year period or subjects with risk SCORE<5% non-deceased during the 10-year period). In French general population aged 35-64, the SCORE equation adequately predicts CV death.