![]() ![]() Numerous multivariable risk scores have been developed to estimate a patient’s 10 year risk of cardiovascular disease based on certain key known risk factors, 1 2 including the Framingham risk score 3 and the Reynolds risk score, 4 both developed using patient data from US, the SCORE system using patients from multiple European countries, 5 and ASSIGN using patients from Scotland. In the United Kingdom, there are almost 200 000 deaths each year relating to diseases of the heart and circulatory system, with more than one in three deaths associated with cardiovascular disease ( General practitioners need an accurate and reliable tool to help them identify patients at high risk of having a cardiovascular event. ![]() Differences in performance between QRISK2 and QRISK1 were marginal.Ĭardiovascular disease is an important health concern globally, with just under a third of all deaths attributed to cardiovascular disease in 2004 ( fact sheet No 317). Similarly, the incidence rate of cardiovascular events (per 1000 person years) among women in the high risk group was 24.3 (23.8 to 24.9) with QRISK2, 20.6 (20.1 to 21.0) with NICE Framingham, and 21.8 (18.9 to 24.6) with QRISK1.Ĭonclusions QRISK2 is more accurate in identifying a high risk population for cardiovascular disease in the United Kingdom than the NICE version of the Framingham equation. The incidence rate of cardiovascular events (per 1000 person years) among men in the high risk group was 27.8 (95% CI 27.4 to 28.2) with QRISK2, 21.9 (21.6 to 22.2) with NICE Framingham, and 24.8 (22.8 to 26.9) with QRISK1. QRISK2 explained 33% of the variation in men and 40% for women, compared with 29% and 34% respectively for the NICE Framingham and 32% and 38% respectively for QRISK1. Discrimination and calibration statistics were better with QRISK2. Results QRISK2 offered improved prediction of a patient’s 10-year risk of cardiovascular disease over the NICE version of the Framingham equation. Main outcome measures First diagnosis of cardiovascular disease (myocardial infarction, angina, coronary heart disease, stroke, and transient ischaemic stroke) recorded in general practice records. ![]() Participants 1.58 million patients registered with a general practice between 1 January 1993 and 20 June 2008, aged 35-74 years (9.4 million person years) with 71 465 cardiovascular events. Setting 365 practices from United Kingdom contributing to The Health Improvement Network (THIN) database. Objective To evaluate the performance of the QRISK2 score for predicting 10-year cardiovascular disease in an independent UK cohort of patients from general practice records and to compare it with the NICE version of the Framingham equation and QRISK1.ĭesign Prospective cohort study to validate a cardiovascular risk score. ![]()
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