Validation of the prognostic index of morbidity and mortality due to cardiovascular disease associated with atherogenic risk factors
Keywords:
cardiovascular risk, prediction models, cardiovascular disease.Abstract
Introduction: The evidence shows that cardiovascular risk prediction equations cannot be applied directly in all populations and require the evaluation of their validity in a new population.Objective: To evaluate whether the prognostic index of morbidity and mortality due to cardiovascular disease associated with atherogenic risk factors is applicable to the general population.
Methods: An external validation study was carried out based on a prospective cohort with 10 years of follow-up, which recruited 700 hypertensive patients free of cardiovascular disease on admission. The number of expected and observed cardiovascular events in those ten years was compared (calibration) and the ability of the risk function to separate high and low risk subjects (discrimination) was estimated.
Results: Significant differences were evidenced between the observed and expected cases, since the low-risk group of 5 expected only reaches 2,5 %, a situation that is reversed in the high-risk group, in which 50 expected events reach an increase 1,62 times (81 patients). Sensitivity values exceed 80% and specificity increased in direct and proportional relationship with the hazard gradient. The area under the ROC curve was 0,78, considered acceptable.
Conclusions: The evaluated prognostic index inadequately calibrates because it overestimates cardiovascular risk, however it appropriately discriminates against people classified as high risk for acquiring atherosclerotic cardiovascular disease.
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References
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5. Rodríguez Perón JM, Mora González SR, Acosta Cabrera EB, Pérez Salido JA, Fernández de la Rosa R, Hernández Sandoval M, et al. Utilización de un índice pronóstico de morbilidad y mortalidad por enfermedad cardiovascular asociada con factores de riesgo aterogénico. Rev Cubana Med Milit. 2002[acceso: 19/01/2020]; 31(2):87-93. Disponible en: https://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0138-65572002000200003&lng=es
6. Argentina Rodríguez A, Alfredo Murillo A, José Rivera R, Enrique Montalván E, Gabriela Duarte K, Alejandro Urrutia S, et al. Validez de los métodos de predicción para riesgo cardiovascular en América Latina: revisión bibliográfica. REV MED HONDUR. 2017[acceso: 19/01/2020]; 85(1y2):51-5. Disponible en: https://www.bvs.hn/RMH/pdf/2017/pdf/Vol85-1-2-2017-15.pdf
7. Gulayin PE, Danaei G, Gutierrez L, Poggio R, Ponzo J, Lanas F, et al. Validación externa de ecuaciones de riesgo cardiovascular en el Cono Sur de Latinoamérica: ¿cuál predice mejor? Rev Argent Cardiol. 2018[acceso: 19/01/2020]; 86(1):14-19. Disponible en: https://www.sac.org.ar/wp-content/uploads/2018/05/v86n1a04.pdf
Published
2021-01-01
How to Cite
1.
Rodríguez Perón JM. Validation of the prognostic index of morbidity and mortality due to cardiovascular disease associated with atherogenic risk factors. Rev Cubana Med Milit [Internet]. 2021 Jan. 1 [cited 2025 Jan. 11];50(1):e0210838. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/838
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