Predictive accuracy of original and recalibrated Framingham risk score in the Swiss population.
OBJECTIVE
To compare the predictive accuracy of the original and recalibrated Framingham risk function on current morbidity from coronary heart disease (CHD) and mortality data from the Swiss population.


METHODS
Data from the CoLaus study, a cross-sectional, population-based study conducted between 2003 and 2006 on 5,773 participants aged 35-74 without CHD were used to recalibrate the Framingham risk function. The predicted number of events from each risk function were compared with those issued from local MONICA incidence rates and official mortality data from Switzerland.


RESULTS
With the original risk function, 57.3%, 21.2%, 16.4% and 5.1% of men and 94.9%, 3.8%, 1.2% and 0.1% of women were at very low (<6%), low (6-10%), intermediate (10-20%) and high (>20%) risk, respectively. With the recalibrated risk function, the corresponding values were 84.7%, 10.3%, 4.3% and 0.6% in men and 99.5%, 0.4%, 0.0% and 0.1% in women, respectively. The number of CHD events over 10 years predicted by the original Framingham risk function was 2-3 fold higher than predicted by mortality+case fatality or by MONICA incidence rates (men: 191 vs. 92 and 51 events, respectively). The recalibrated risk function provided more reasonable estimates, albeit slightly overestimated (92 events, 5-95th percentile: 26-223 events); sensitivity analyses showed that the magnitude of the overestimation was between 0.4 and 2.2 in men, and 0.7 and 3.3 in women.


CONCLUSIONS
The recalibrated Framingham risk function provides a reasonable alternative to assess CHD risk in men, but not in women.
Marques-Vidal
Pedro
P
Centre for Cardiovascular and Metabolic Research, Cardiomet, Switzerland. Pedro-Manuel.Marques-Vidal@chuv.ch
Rodondi
Nicolas
N
Bochud
Murielle
M
Chiolero
Arnaud
A
Pécoud
Alain
A
Hayoz
Daniel
D
Paccaud
Fred
F
Mooser
Vincent
V
Firmann
Mathieu
M
Waeber
Gérard
G
Vollenweider
Peter
P
D000328:Adult; D000368:Aged; D002138:Calibration; D003327:Coronary Disease / Q000175:diagnosis* / Q000453:epidemiology* / Q000401:mortality; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D044382:Population Groups; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D013557:Switzerland / Q000453:epidemiology