Cardiovascular risk of SCORE compared to Framingham.: Consequences of the change proposed by the European Societies

BACKGROUND AND OBJECTIVE: The European Societies in their last update introduce substantial changes to calculate the cardiovascular risk without thinking about the practical consequences. The objective was to evaluate the agreement between the charts of cardiovascular risk of second and the third recommendations of the European Societies to classify the patients of high risk and to analyze its differences. PATIENTS AND METHOD: Patients (1,227) belonging to 3 primary care centres. Risk calculated to the 10 years by means of the equation of Framingham and SCORE for countries lowers risk. A risk of Framingham greater than or equal to 20% or SCORE greater than or equal to 5% defined the high risk. RESULTS: The patients of high risk were 8.4% according to Framingham and 5.5% according to SCORE and the coefficient Kappa 0.718. 41.7% of the patients of high risk disagreed: high risk Framingham and SCORE not (40 patients, 88.9%) and high SCORE and Framingham not (5 patients, 11.1%). The group high risk Framingham and SCORE not 1 is constituted by 95% of males, age 60 years, cholesterol 246.2 mg/dl and 37.5% smokers. CONCLUSIONS The chart SCORE and Framingham have an acceptable agreement, but classify from high risk different percentage of population and with different characteristics. The use of the chart of the SCORE would exclude an important group of patients with Framingham high risk.