Elsevier

Indian Heart Journal

Volume 67, Issue 4, July–August 2015, Pages 332-340
Indian Heart Journal

Original Article
Relationship between different cardiovascular risk scores and measures of subclinical atherosclerosis in an Indian population

https://doi.org/10.1016/j.ihj.2015.04.017Get rights and content
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Abstract

Background

Relative accuracy of the various currently available cardiovascular (CV) risk assessment algorithms in Indian patients is not known.

Methods

This study included 194 consecutive patients (mean age 49.6 ± 10.3 years, 84.5% males) attending a CV disease prevention clinic at a tertiary center in north India. Four risk assessment models [Framingham Risk score (RiskFRS), American College of Cardiology/American Heart Association pooled cohort equations (RiskACC/AHA), the 3rd iteration of Joint British Societies' risk calculator (RiskJBS) and the World Health Organization/International Society of Hypertension risk prediction charts (RiskWHO)] were applied. The estimated risk scores were correlated with carotid intima-media thickness (CIMT) and coronary calcium score (CCS) using nonparametric statistics (Chi-square test, Kruskal–Wallis test and Spearman rank correlation).

Results

Overall, RiskACC/AHA and RiskWHO significantly underestimated CV risk as compared to RiskJBS and RiskFRS, with RiskJBS being the least likely to underestimate the risk (patients with coronary artery disease who were found to have ≥20% CV risk- 21.4% with RiskACC/AHA, 17.9% with RiskWHO, 41.4% with RiskFRS, and 58.6% with RiskJBS). Further, only RiskJBS and RiskFRS, but not RiskACC/AHA and RiskWHO, demonstrated consistent relationship with CIMT and CCS (Spearman rho 0.45 and 0.46 for RiskJBS and 0.39 and 0.36 for RiskFRS for CIMT and CCS respectively, all p values < 0.001).

Conclusions

The present study shows that in Indian subjects RiskJBS appears to provide the most accurate estimation of CV risk. It least underestimates the risk and has the best correlation with CIMT and CCS. However, large-scale prospective studies are needed to confirm these findings.

Keywords

Atherosclerotic cardiovascular disease
Primary prevention
Risk stratification

Cited by (0)

Place of work: Medanta – The Medicity, Sector 38, Gurgaon 122001, India.