[Validation of 3 equations of coronary risk in diabetic population of a primary care center].
OBJECTIVE
We intended to validate to 10 years 3 equations of coronary risk that use the function of original Framingham (Framingham-Anderson and Framingham-Wilson) and calibrated for Spanish population (Framingham-REGICOR) in diabetic patients type 2.


METHODS
We included a total of 190 diabetic patients from a primary care center, without coronary heart disease, in whom the coronary risk could be calculated before 1 January 1995. All were followed during 10 years.


RESULTS
The highest score of cardiovascular risk was obtained in the Framingham-Wilson function chart (25.4%) and the lowest in the Framingham-REGICOR (10.8%). The real incidence of coronary events was 14.7% (p < 0.001). Statistically significant differences between patients with or without coronary events were only observed in the Framingham-REGICOR equation (13.3% vs 10.3%; p = 0.046). Framingham-Anderson and Framingham-Wilson functions charts more than doubled the risk of coronary disease in men (p < 0.001). The agreement degree between the 3 functions was acceptable except for the calculation of coronary risk in men between Framingham-REGICOR and Framingham-Wilson equations (kappa index = 0.3). Framingham-Anderson and Framingham-Wilson functions charts showed similar profiles for the patients with high coronary risk. Sensitivity was superior in Framingham-Anderson and Framingham-Wilson functions (67.8%) and specificity was optimal in Framingham-REGICOR equation (51.2%). The positives predictive values were low and the negatives predictive values were high.


CONCLUSIONS
The equations of Framingham-Wilson and Framingham-Anderson overestimate the coronary risk in diabetics, whereas the Framingham-REGICOR functions underestimates it. The utility of these 3 methods is reduced in the diabetic population.
Cañón-Barroso
Lourdes
L
Unidad Docente de Medicina Familiar y Comunitaria, Centro de Salud Universitario La Paz, Badajoz, Spain.
Cruces-Muro
Eloísa
E
Fernández-Ochoa
Gerardo
G
Nieto-Hernández
Teresa
T
García-Vellido
Andrés
A
Buitrago
Francisco
F
D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D002391:Catchment Area, Health; D003327:Coronary Disease / Q000453:epidemiology* / Q000209:etiology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011320:Primary Health Care; D015203:Reproducibility of Results; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology