Increased discordance between HeartScore and coronary artery calcification score after introduction of the new ESC prevention guidelines. Issue 1 (March 2015)

• Record Type: Journal Article
• Authors: Diederichsen, Axel C.P.; Mahabadi, Amir-Abbas; Gerke, Oke; Lehmann, Nils; Sand, Niels P.; Moebus, Susanne; Lambrechtsen, Jess; Kälsch, Hagen; Jensen, Jesper M.; Jöckel, Karl-Heinz; Mickley, Hans; Erbel, Raimund
• Is Part Of: Atherosclerosis. Volume 239:Issue 1(2015)
• Page Start: 143
• Page End: 149
• Publication Date: 2015-03
• Subjects: Arteriosclerosis -- Periodicals; Electronic journals; 616.136
• DOI: 10.1016/j.atherosclerosis.2015.01.005
• Languages: English
• ISSNs: 0021-9150

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Abstract</title> <sec> <title id="sectitle0015">Objectives</title> <p id="abspara0010">The European HeartScore has traditionally differentiated between low and high-risk countries. Until 2012 Germany and Denmark were considered to be high-risk countries but have now been defined as low-risk countries. In this survey we aim to address the consequences of this downgrading.</p> </sec> <sec> <title id="sectitle0020">Methods</title> <p id="abspara0015">A screening of 3932 randomly selected (mean age 56 years, 46% male) individuals from Germany and Denmark free of cardiovascular disease was performed. Traditional risk factors were determined, and the HeartScore was measured using both the low-risk and the high-risk country models. A non-contrast Cardiac-CT scan was performed to detect coronary artery calcification (CAC).</p> </sec> <sec> <title id="sectitle0025">Results</title> <p id="abspara0020">Agreement of HeartScore risk groups with CAC groups was poor, but higher when applying the algorithm for the low-risk compared to the high-risk country model (agreement rate: 77% versus 63%, and weighted Kappa: 0.22 versus 0.15). However, the number of subjects with severe coronary calcification (CAC score ≥400) increased in the low and intermediate HeartScore risk group from 78 to 147 participants (from 2.7 % to 4.2 %, p = 0.001), when estimating the risk based on the algorithm for low-risk countries.</p> </sec> <sec> <title id="sectitle0030">Conclusion</title> <p id="abspara0025">As a consequence of the reclassification of Germany and Denmark as low-risk countries more people with severe atherosclerosis will be classified as having a low or intermediate risk of fatal cardiovascular disease.</p> </sec> </abstract>