Background: The prevention of cardiovascular disease (CVD) is important in clinical practice due to its high morbidity and mortality. Different guidelines have recommended the use of different cardiovascular risk assessment tools, which may have implications on therapeutic decisions. Objective: To evaluate the agreement rate between the Framingham risk score (FRS) and the Systematic Coronary Risk Evaluation (SCORE) tool on CVD risk assessment in disease-free subjects. Methods: Cross-sectional study with a sample of 51 subjects treated at the outpatient clinic of a university hospital in Brazil between January 2014 and January 2015. The FRS and two versions of the European SCORE (SCORE-High and SCORE-Low) were used to assess CVD risk; patients were classified as low/moderate risk (< 20% and <5%, respectively) or high risk (≥ 20% and ≥5%, respectively). The agreement rate was evaluated using kappa statistics, a test for interrater reliability that ranges from-1 to 1, and results above 0.6 represent a high agreement rate. Results: The FRS classified a higher proportion of subjects as high risk for CVD (35.3% [18/51] vs. 23.5% [12/51] with the SCORE-High and 13.7% [7/51] with SCORE-Low). However, there was a high agreement rate between FRS and SCORE-High (k=0.628). The agreement between FRS and SCORE-Low was poor (k=0.352). Conclusions: There was a high agreement rate between FRS and SCORE-High in cardiovascular risk assessment in the study sample.
BackgroundCardiovascular disease (CVD) is the leading cause of morbidity and mortality
in Brazil, and primary prevention care may be guided by risk stratification
tools. The Framingham (FRS) and QRISK-2 (QRS) risk scores estimate 10-year
overall cardiovascular risk in asymptomatic individuals, but the instrument
of choice may lead to different therapeutic strategies.ObjectiveTo evaluate the degree of agreement between FRS and QRS in 10-year overall
cardiovascular risk stratification in disease-free individuals.MethodsCross-sectional, observational, descriptive and analytical study in a
convenience sample of 74 individuals attending the outpatient care service
of a university hospital in Brazil between January 2014 and January 2015.
After application of FRS and QRS, patients were classified in low/moderate
risk (< 20%) or high risk (≥ 20%).ResultsThe proportion of individuals classified as at high risk was higher in FRS
than in QRS (33.7% vs 21.6%). A synergic effect of male gender with systemic
arterial hypertension was observed in both tools, and with for geriatric age
group in QRS (p < 0.05) in high-risk stratum. The Kappa index was 0.519
(95%CI = 0.386-0.652; p < 0.001) between both instruments.ConclusionThere was a moderate agreement between FRS and QRS in estimating 10-year
overall cardiovascular risk. The risk scores used in this study can identify
synergism between variables, and their behavior is influenced by the
population in which it was derived. It is important to recognize the need
for calibrating risk scores for the Brazilian population.
Cutaneous plasmacytosis is a rare dermatosis that is classically characterized by the presence of multiple papules and reddish- -brown nodules mainly in the trunk. It most commonly affects elderly Asians, with few reports in Caucasians and young patients. On histopathology there is a polyclonal proliferation of mature plasm cells. The objective of this report is to present a case of atypical manifestation of this rare disease, both due to clinical and epidemiological aspects.
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