Framingham risk score and alternatives for prediction of coronary heart disease in older adults.

Détails

Ressource 1Télécharger: BIB_50F9A5C935B8.P001.pdf (176.59 [Ko])
Etat: Serval
Version: Final published version
ID Serval
serval:BIB_50F9A5C935B8
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Framingham risk score and alternatives for prediction of coronary heart disease in older adults.
Périodique
Plos One
Auteur(s)
Rodondi N., Locatelli I., Aujesky D., Butler J., Vittinghoff E., Simonsick E., Satterfield S., Newman A.B., Wilson P.W., Pletcher M.J., Bauer D.C.
Collaborateur(s)
Health ABC Study
ISSN
1932-6203 (Electronic)
ISSN-L
1932-6203
Statut éditorial
Publié
Date de publication
2012
Peer-reviewed
Oui
Volume
7
Numéro
3
Pages
e34287 [8 p.]
Langue
anglais
Notes
Publication types: Journal Article
Résumé
BACKGROUND: Guidelines for the prevention of coronary heart disease (CHD) recommend use of Framingham-based risk scores that were developed in white middle-aged populations. It remains unclear whether and how CHD risk prediction might be improved among older adults. We aimed to compare the prognostic performance of the Framingham risk score (FRS), directly and after recalibration, with refit functions derived from the present cohort, as well as to assess the utility of adding other routinely available risk parameters to FRS.¦METHODS: Among 2193 black and white older adults (mean age, 73.5 years) without pre-existing cardiovascular disease from the Health ABC cohort, we examined adjudicated CHD events, defined as incident myocardial infarction, CHD death, and hospitalization for angina or coronary revascularization.¦RESULTS: During 8-year follow-up, 351 participants experienced CHD events. The FRS poorly discriminated between persons who experienced CHD events vs. not (C-index: 0.577 in women; 0.583 in men) and underestimated absolute risk prediction by 51% in women and 8% in men. Recalibration of the FRS improved absolute risk prediction, particulary for women. For both genders, refitting these functions substantially improved absolute risk prediction, with similar discrimination to the FRS. Results did not differ between whites and blacks. The addition of lifestyle variables, waist circumference and creatinine did not improve risk prediction beyond risk factors of the FRS.¦CONCLUSIONS: The FRS underestimates CHD risk in older adults, particularly in women, although traditional risk factors remain the best predictors of CHD. Re-estimated risk functions using these factors improve accurate estimation of absolute risk.
Pubmed
Web of science
Open Access
Oui
Création de la notice
03/08/2012 16:28
Dernière modification de la notice
08/05/2019 18:33
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