Valoración del riesgo cardiovascular en la fase transversal del estudio Mediterránea

Gil-Guillén, Vicente Francisco; Merino-Sánchez, Jaime; Sánchez-Ruiz, T.; Amorós-Barber, T.; Aznar-Vicente, J.; Abellan-Alemán, J.; Llisterri-Caro, J.L.; Orozco‐Beltrán, Domingo

doi:10.1016/s0014-2565(09)71237-8

Cited by 8 publications

(6 citation statements)

References 30 publications

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“…[10][11][12][14][15][16] Moreover, none of them included individuals with documented CVD or considered HDL-C in the risk equation, and only some included diabetic patients. 10,11,13,16,17 Sex differences in CVR in Spain have been reported in previous studies. Jansen-Chaparro et al 12 and Mostaza et al 14 showed that the prevalence of high/very-high risk in men and women was 6.9% and 0.5%, and 8.2% and 0.2%, respectively.…”

Section: Discussionsupporting

confidence: 66%

“…Most of the previous studies investigating CVR in Spain were focused on patients with prespecified medical conditions (metabolic syndrome, or presence of one or more traditional risk factors) 12,13 or were limited to regions that might not be representative of the whole national territory. [10][11][12][14][15][16] Moreover, none of them included individuals with documented CVD or considered HDL-C in the risk equation, and only some included diabetic patients.…”

Section: Discussionmentioning

confidence: 99%

“…9 In Spain, there are only a few studies designed to describe CVR at the population level. [10][11][12][13][14][15][16][17] These studies are either limited by their sample size, or focused on specific groups with at least one of the classical cardiovascular risk factors (CVRF), or performed in specific regions that may not be representative of the entire country. Furthermore, none of these surveys included high-density lipoprotein cholesterol (HDL-C) in the estimation of CVR.…”

Section: Introductionmentioning

confidence: 99%

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Estimating Cardiovascular Risk in Spain by the European Guidelines on Cardiovascular Disease Prevention in Clinical Practice

Amor

Masana

Soriguer

et al. 2015

Revista Española de Cardiología (English Edition)

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Estimating Cardiovascular Risk in Spain by the European Guidelines on Cardiovascular Disease Prevention in Clinical Practice

Amor

Masana

Soriguer

et al. 2015

Revista Española de Cardiología (English Edition)

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“…In our opinion, the current state of the FRAX needs some adjustments such as those proposed in this study. Something similar to this need for adaptation and adjustments happened in Spain with the application of the first Framingham-type cardiovascular risk scales which required adaptations such as the REGICOR scale and others in our country [44-46]. …”

Section: Discussionmentioning

confidence: 99%

FRAX® tool, the WHO algorithm to predict osteoporotic fractures: the first analysis of its discriminative and predictive ability in the Spanish FRIDEX cohort

Azagra

Roca

Encabo

et al. 2012

BMC Musculoskelet Disord

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BackgroundThe WHO has recently published the FRAX® tool to determine the absolute risk of osteoporotic fracture at 10 years. This tool has not yet been validated in Spain.Methods/designA prospective observational study was undertaken in women in the FRIDEX cohort (Barcelona) not receiving bone active drugs at baseline. Baseline measurements: known risk factors including those of FRAX® and a DXA. Follow up data on self-reported incident major fractures (hip, spine, humerus and wrist) and verified against patient records. The calculation of absolute risk of major fracture and hip fracture was by FRAX® website. This work follows the guidelines of the STROBE initiative for cohort studies. The discriminative capacity of FRAX® was analyzed by the Area Under Curve (AUC), Receiver Operating Characteristics (ROC) and the Hosmer-Lemeshow goodness-of-fit test. The predictive capacity was determined using the ratio of observed fractures/expected fractures by FRAX® (ObsFx/ExpFx).ResultsThe study subjects were 770 women from 40 to 90 years of age in the FRIDEX cohort. The mean age was 56.8 ± 8 years. The fractures were determined by structured telephone questionnaire and subsequent testing in medical records at 10 years. Sixty-five (8.4%) women presented major fractures (17 hip fractures). Women with fractures were older, had more previous fractures, more cases of rheumatoid arthritis and also more osteoporosis on the baseline DXA. The AUC ROC of FRAX® for major fracture without bone mineral density (BMD) was 0.693 (CI 95%; 0.622-0.763), with T-score of femoral neck (FN) 0.716 (CI 95%; 0.646-0.786), being 0.888 (CI 95%; 0.824-0.952) and 0.849 (CI 95%; 0.737-0.962), respectively for hip fracture. In the model with BMD alone was 0.661 (CI 95%; 0.583-0.739) and 0.779 (CI 95%; 0.631-0.929). In the model with age alone was 0.668 (CI 95%; 0.603-0.733) and 0.882 (CI 95%; 0.832-0.936). In both cases there are not significant differences against FRAX® model. The overall predictive value for major fracture by ObsFx/ExpFx ratio was 2.4 and 2.8 for hip fracture without BMD. With BMD was 2.2 and 2.3 respectively. Sensitivity of the four was always less than 50%. The Hosmer-Lemeshow test showed a good correlation only after calibration with ObsFx/ExpFx ratio.ConclusionsThe current version of FRAX® for Spanish women without BMD analzsed by the AUC ROC demonstrate a poor discriminative capacity to predict major fractures but a good discriminative capacity for hip fractures. Its predictive capacity does not adjust well because leading to underdiagnosis for both predictions major and hip fractures. Simple models based only on age or BMD alone similarly predicted that more complex FRAX® models.

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“…In Spain this was done by using prevalence not incidence [8] and one calibration [9] have been made. Likewise, our group tried to validate the scales using incidences but with only one year of follow-up [10,11]. …”

Section: Introductionmentioning

confidence: 99%

Rationale and methods of the cardiometabolic valencian study (escarval-risk) for validation of risk scales in mediterranean patients with hypertension, diabetes or dyslipidemia

et al. 2010

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BackgroundThe Escarval-Risk study aims to validate cardiovascular risk scales in patients with hypertension, diabetes or dyslipidemia living in the Valencia Community, a European Mediterranean region, based on data from an electronic health recording system comparing predicted events with observed during 5 years follow-up study.Methods/DesignA cohort prospective 5 years follow-up study has been designed including 25000 patients with hypertension, diabetes and/or dyslipidemia attended in usual clinical practice. All information is registered in a unique electronic health recording system (ABUCASIS) that is the usual way to register clinical practice in the Valencian Health System (primary and secondary care). The system covers about 95% of population (near 5 million people). The system is linked with database of mortality register, hospital withdrawals, prescriptions and assurance databases in which each individual have a unique identification number. Diagnoses in clinical practice are always registered based on IDC-9. Occurrence of CV disease was the main outcomes of interest. Risk survival analysis methods will be applied to estimate the cumulative incidence of developing CV events over time.DiscussionThe Escarval-Risk study will provide information to validate different cardiovascular risk scales in patients with hypertension, diabetes or dyslipidemia from a low risk Mediterranean Region, the Valencia Community.

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Valoración del riesgo cardiovascular en la fase transversal del estudio Mediterránea

Cited by 8 publications

References 30 publications

Estimating Cardiovascular Risk in Spain by the European Guidelines on Cardiovascular Disease Prevention in Clinical Practice

Estimating Cardiovascular Risk in Spain by the European Guidelines on Cardiovascular Disease Prevention in Clinical Practice

FRAX® tool, the WHO algorithm to predict osteoporotic fractures: the first analysis of its discriminative and predictive ability in the Spanish FRIDEX cohort

Rationale and methods of the cardiometabolic valencian study (escarval-risk) for validation of risk scales in mediterranean patients with hypertension, diabetes or dyslipidemia

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