[Assessment of the absolute global cardiovascular risk: comparison between the risk chart and the individual score of the CUORE Project].
BACKGROUND
To evaluate 10-year cardiovascular risk, the risk chart and the individual risk score from the CUORE Project were recently introduced in Italy. These tools differ as for age range and some risk factors. Therefore, the aim of this study is to evaluate the difference between the global absolute risk assessed by the risk chart and the individual risk score using the data collected through the Osservatorio Epidemiologico Cardiovascolare (OEC).


METHODS
From the Osservatorio Epidemiologico Cardiovascolare sample, 6508 people aged 40-69 years without clinical manifestations of atherosclerosis were selected. Cardiovascular risk was assessed using risk chart and individual risk score and the 10-year risk was categorized in six classes (< 5%, 5-9%, 10-14%, 15-19%, 20-29%, > or = 30%). As coefficient of agreement between risk chart and individual risk score, Cohen kappa statistic was computed using the Cicchetti-Allison weights (k(w)).


RESULTS
From contingency tables of the two methods distribution, k(w) was 0.71 (p < 0.0001 and 95% confidence interval 0.70-0.72). Using the 20% risk threshold reported in Nota 13 of Agenzia Italiana del Farmaco and excluding persons who were treated for hyperlipemia refunded regardless of their chart or individual score estimation of cardiovascular risk, the differences between the two tools classification resulted in the 2.6% of the sample (1.4% were assessed as at non-high risk [< 20%] using the risk chart and at high risk using the individual risk score, and the opposite for 1.2%).


CONCLUSIONS
Classification difference between risk charts and the individual risk score is quite small. Updating of predictive functions of two tools could improve their concordance also for individual evaluation, including older people and better reflecting current Italian lifestyle.
Giampaoli
Simona
S
Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, Roma. sgiamp@iss.it
Palmieri
Luigi
L
Donfrancesco
Chiara
C
Panico
Salvatore
S
Pilotto
Lorenza
L
Addis
Antonio
A
Boccanelli
Alessandro
A
Di Pasquale
Giuseppe
G
Brignoli
Ovidio
O
Filippi
Alessandro
A
Vanuzzo
Diego
D
D000328:Adult; D000367:Age Factors; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D016001:Confidence Intervals; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012737:Sex Factors