Utilization of Risk Scores for Coronary Heart Disease Diagnosis in Rural China

Abstract

Objective: The current study was to design a cardiovascular risk score for the diagnosis of coronary heart disease (CHD) in the rural area of China and the sensitivity and specificity of this score would be assessed.

Methods: A total of 520 patients were enrolled and based on the results from coronary artery angiography, patients were divided into three groups: CHD group (coronary artery ≥50% stenosis), atherosclerosis group (coronary artery <50% stenosis) and normal groups (without stenosis). Between-group differences were evaluated and the sensitivity and specificity of cardiovascular risk score were evaluated.

Results: Compared to the normal and atherosclerosis groups, patients in the CHD group were older, had higher body mass index, and more likely to be smoking and obese, and had dyslipidemia, hypertension and diabetes, and had higher cardiovascular risk score (4.05 ± 2.15 vs 2.94 ± 1.90 vs 2.54 ± 1.59). Patients in the CHD group were more likely to have cardiovascular risk scores ≥2 (90.2% CHD group vs 74.2% atherosclerosis group vs 76.1% normal group, P < 0.05). The area under the ROC was 0.673, with 95% confidence interval was 0.623-0.722 (P < 0.001), and the sensitivity and specificity were highest when the cardiovascular risk score was 4, indicating that the value of cardiovascular risk score of 4 was a good cutoff point for CHD diagnosis.

Conclusion: Using cardiovascular risk score can improve CHD diagnosis which may help to reduce health disparities between rural and urban area.

Keywords: cardiovascular risk score; coronary heart disease; sensitivity; specificity.

Figure 1

Performance of risk score. The area under the ROC was 0.673, with 95% confidence interval was 0.623–0.722 (P < 0.001).