Abstract
Objective: To investigate the concordance between the modified Framingham score using the ankle-brachial index and the high-sensitivity C-reactive protein with the other scores. Materials and method: Cross-sectional study nested with a cohort, with elderly population, from January to March, 2018. The population characterization was presented as mean, median, absolute and relative frequencies according to degree of normality. The Kappa concordance of the modified Framingham score was calculated with the Framingham score itself, with the Systematic Coronary Risk Evaluation (Score) and with the Prospective Cardiovascular Munster (Procam). Results: The modified Framingham score shows moderate Kappa concordance with the Framingham score and the Score (p < 0.001), but weak with Procam. The ultra-sensitive C-reactive protein presented more reclassification of individuals among risk strata than the ankle-brachial index. Conclusions: The Framingham score modified with the Framingham score itself, and then with the Score obtained a higher proportion of concordant cases in the high-risk stratum. High-sensitivity C-reactive protein and the ankle-brachial index modify cardiovascular risk as emerging factors to provide an accurate risk stratification and to infer better management of the therapy. Thus, the Framingham score with its reclassification is the best screening tool for cardiovascular risk.
Highlights
The most commonly used cardiovascular risk stratifications are the Framingham Risk Score (FRS), the Systematic Coronary Risk Evaluation (Score) and the Prospective Cardiovascular Munster (Procam)
Some authors suggest that Procam, Framingham and other scores do not represent, in their entirety, cardiovascular risk by not including biomarkers of inflammatory activity, for example, in their calculation. [3]
The Kappa statistic showed a weak agreement between the modified FRS and Procam, and a moderate agreement with the reclassified FRS and the FRS, as well as the Score
Summary
The most commonly used cardiovascular risk stratifications are the Framingham Risk Score (FRS), the Systematic Coronary Risk Evaluation (Score) and the Prospective Cardiovascular Munster (Procam). As well as other cardiovascular risk prediction scores, is used in specific groups such as patients with rheumatoid arthritis, recommended by organizations such as the European League Against Rheumatism (Eular). This score, by means of age, gender, total cholesterol levels, systolic blood pressure (SBP) and tobacco use [2], estimates mortality from cardiovascular disease (CVD) and atherosclerotic events. Like the others, estimates the risk of developing cardiovascular disease in ten years and has the variables LDLcholesterol, triglycerides, diabetes and a family history of CVD. Some authors suggest that Procam, Framingham and other scores do not represent, in their entirety, cardiovascular risk by not including biomarkers of inflammatory activity, for example, in their calculation. [3]
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