Abstract
PURPOSE: Assessment of cardiovascular (CV) risk with a predictive algorithm is recommended for managing CV disease prevention. The aim of this study was to assess the predictive accuracy of the European Society of Cardiology SCORE among French people.
METHODS: Our analysis was based on the Third French MONICA population-based survey (1995-1996) and on a sample of subjects referred (from 1995 to 2000) for a CV checkup in a preventive cardiology unit. Vital status was obtained 10 years after inclusion. The 10-year predicted risk of CV death was calculated using the SCORE equation for low-risk countries and was compared with the 10-year incidence of CV death observed in the cohort.
RESULTS: The sample was composed of 6915 participants aged 35 to 64 years, among whom 56 CV deaths occurred during the followup. The median risk SCORE (0.97%) did not differ from the 10-year incidence of CV death observed in the cohort (1.05%; 95% CI, 0.81-1.37). The median risk SCORE calculated for different categories of sex, age, educational level, family history of premature CV disease, physical activity, impaired fasting glucose, smoking, systolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol did not differ from the 10-year incidence of CV death observed in these categories. The C-statistic of the SCORE equation was 79% (73-85). Using a 5% threshold to discriminate people at high risk, 93% of participants were correctly classified (subjects with SCORE >=5% who died from a CV causes during followup and those with SCORE <5% who did not).
CONCLUSIONS: Among middle-aged French people, the SCORE equation adequately predicts CV death.