期刊论文详细信息
INTERNATIONAL JOURNAL OF CARDIOLOGY 卷:293
Validation of the Systematic COronary Risk Evaluation - Older Persons (SCORE-OP) in the EPIC-Norfolk prospective population study
Article
Verweij, Lotte1  Peters, Ron J. G.2  Reimer, Wilma J. M. Scholte Op1,2,3  Boekholdt, Matthijs S.2  Luben, Robert M.4  Wareham, Nicholas J.4  Khaw, Kay-Tee5  Latour, Corine H. M.1  Jorstad, Harald T.2 
[1] Amsterdam Univ Appl Sci, Ctr Appl Res, ACHIEVE, Tafelbergweg 51, NL-1105 BD Amsterdam, Netherlands
[2] Univ Amsterdam, Amsterdam UMC, Dept Cardiol, Amsterdam, Netherlands
[3] Amsterdam Univ Appl Sci, Fac Sports & Nutr, Amsterdam, Netherlands
[4] Univ Cambridge, Med Res Council Epidemiol Unit, Cambridge, England
[5] Univ Cambridge, Dept Publ Hlth & Primary Care, Cambridge, England
关键词: Primary prevention;    Cardiovascular disease;    Mortality;    Risk prediction;    Aged;   
DOI  :  10.1016/j.ijcard.2019.07.020
来源: Elsevier
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【 摘 要 】

Background: The Systematic COronary Risk Evaluation - Older Persons (SCORE-OP) algorithm is developed to assess 10-year risk of death due to cardiovascular disease (CVD) in individuals aged >= 65 years. We studied the performance of SCORE-OP in the European Prospective Investigation of Cancer Norfolk (EPIC-Norfolk) prospective population cohort. Methods: 10-year CVD mortality as predicted by SCORE-OP was compared with observed CVD mortality among individuals in the EPIC-Norfolk cohort. Persons aged 65-79 years without known CVD were included in the analysis. CVD mortality was defined as death due to ischemic heart disease, cardiac failure, cerebrovascular disease, peripheral-artery disease or aortic aneurysm. Predicted 10-year CVD mortality was calculated by the SCORE-OP algorithm, and compared to observed mortality rates. The area under the receiver operator characteristics curve (AUROC) was calculated to evaluate discriminative power. Calibration was evaluated by calculating ratios of predicted vs observed mortality and by Hosmer-Lemeshow tests. Results: A total of 6590 individuals (45.8% men), mean age 70.2 years (standard deviation 3.3) were included. The predicted mortality by SCORE-OP was 9.84% (95% confidence interval (CI) 9.76-9.92) and observed mortality was 10.2% (95% CI 9.52-11.04), ratio 0.96. AUROC was 0.63 (95% CI 0.60-0.65), and X-2 was 3.3 (p = 0.92). Conclusion: SCORE-OP overall accurately estimates the rate of CVD mortality in a general population aged 65-79 years. However, while calibration is excellent, the discriminative power of the SCORE-OP is limited, and as such cannot be readily implemented in clinical practice for this population. (C) 2019 The Authors. Published by Elsevier B.V.

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