Increased discordance between HeartScore and coronary artery calcification score after introduction of the new ESC prevention guidelines

Axel C P Diederichsen, Amir-Abbas Mahabadi, Oke Gerke, Nils Lehmann, Niels P Sand, Susanne Moebus, Jess Lambrechtsen, Hagen Kälsch, Jesper M Jensen, Karl-Heinz Jöckel, Hans Mickley, Raimund Erbel

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

Abstract

OBJECTIVES: 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.

METHODS: 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).

RESULTS: 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.

CONCLUSION: 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.

Original languageEnglish
JournalAtherosclerosis
Volume239
Issue1
Pages (from-to)143-149
Number of pages7
ISSN0021-9150
DOIs
Publication statusPublished - 15 Jan 2015

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