Common clinical practice versus new PRIM score in predicting coronary heart disease risk.
OBJECTIVE
To compare the new Patient Rule Induction Method (PRIM) Score and common clinical practice with the Framingham Point Score for classification of individuals with respect to coronary heart disease (CHD) risk.


RESULTS
PRIM Score and the Framingham Point Score were estimated for 11,444 participants from the Copenhagen City Heart Study. Gender specific cumulative incidences and 10 year absolute CHD risks were estimated for subsets defined by age, total cholesterol, high-density lipoprotein (HDL) cholesterol, blood pressure, diabetes and smoking categories. PRIM defined seven mutually exclusive subsets in women and men, with cumulative incidences of CHD from 0.01 to 0.22 in women, and from 0.03 to 0.26 in men. PRIM versus Framingham Point Score found 11% versus 4% of all women, and 31% versus 35% of all men to have 10 year CHD risks>20%. Among women ≥ 65 years with hypertension and/or with diabetes, 10 year CHD risk>20% was found for 100% with PRIM scoring but for only 18% with the Framingham Point Score.


CONCLUSIONS
Compared to the PRIM Score, common clinical practice with the Framingham Point Score underestimates CHD risk in women, especially in women≥65 years with hypertension and/or with diabetes.
Frikke-Schmidt
Ruth
R
Department of Clinical Biochemistry, Rigshospitalet, Denmark. ruth.frikke-schmidt@rh.regionh.dk
Tybjærg-Hansen
Anne
A
Schnohr
Peter
P
Jensen
Gorm B
GB
Nordestgaard
Børge G
BG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D003327:Coronary Disease / Q000453:epidemiology / Q000209:etiology*; D003718:Denmark / Q000453:epidemiology; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects
D008076:Cholesterol, HDL; D002784:Cholesterol