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. 2024 May 24:21:200287.
doi: 10.1016/j.ijcrp.2024.200287. eCollection 2024 Jun.

Comparison of atherosclerotic cardiovascular disease (ASCVD) and Framingham risk scores (FRS) in an Iranian population

Matin Sepehrinia  1   2 , Hossein Pourmontaseri  1 , Mehrab Sayadi  3 , Mohammad Mehdi Naghizadeh  2 , Reza Homayounfar  4 , Mojtaba Farjam  2 , Azizallah Dehghan  2 , Abdulhakim Alkamel  2   5
Affiliations

Comparison of atherosclerotic cardiovascular disease (ASCVD) and Framingham risk scores (FRS) in an Iranian population

Matin Sepehrinia et al. Int J Cardiol Cardiovasc Risk Prev. .

Abstract

Background: Framingham risk score (FRS) and Atherosclerotic Cardiovascular Disease risk score (ASCVDrs) are widely used tools developed based on the American population. This study aimed to compare the ASCVDrs and FRS in an Iranian population.

Method: The participants of the Fasa Adult Cohort Study and the patients of the cardiovascular database of Vali-Asr Hospital of Fasa, aged 40-80 years, were involved in the present cross-sectional study. After excluding non-eligible participants, the individuals with a history of myocardial infarction or admission to the cardiology ward due to heart failure were considered high-risk, and the others were considered low-risk. The discriminative ability of FRS and ASCVDrs was evaluated and compared using receiver operating characteristic curve analysis. The correlation and agreement of ASCVDrs and FRS were tested using Cohen Kappa and Spearman.

Results: Finally, 8983 individuals (mean age:53.9 ± 9.5 y, 49.2 % male), including 1827 high-risk participants, entered the study. ASCVDrs detected a greater portion of participants as high-risk in comparison with FRS (28.7 % vs. 15.7 %). ASVD (AUC:0.794) had a higher discriminative ability than FRS (AUC:0.746), and both showed better discrimination in women. Optimal cut-off points for both ASCVDrs (4.36 %) and FRS (9.05 %) were lower than the original ones and in men. Compared to FRS, ASCVDrs had a higher sensitivity (79.3 % vs. 71.6 %) and lower specificity (64.5 % vs. 65.1 %). FRS and ASCVDrs had a moderate agreement (kappa:0.593,p-value<0.001) and were significantly correlated (Spearman:0.772,p-value<0.001).

Conclusions: ASCVDrs had a more accurate prediction of cardiovascular events and identified a larger number of people as high-risk in the Iranian population.

Keywords: Iran; Pooled cohort equation; Prevention; Risk assessment; Risk factor; Risk prediction.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Performance of Framingham risk score and ASCVD risk score in total, men, women participants (from left to right).
See this image and copyright information in PMC

References

    1. Roth G.A., et al. Global burden of cardiovascular diseases and risk factors, 1990–2019: update from the GBD 2019 study. J. Am. Coll. Cardiol. 2020;76(25):2982–3021. - PMC - PubMed
    1. Mensah G.A., et al. Global burden of cardiovascular diseases and risks, 1990-2022. J. Am. Coll. Cardiol. 2023;82(25):2350–2473. - PMC - PubMed
    1. Sarrafzadegan N., Mohammmadifard N. Cardiovascular disease in Iran in the last 40 years: prevalence, mortality, morbidity, challenges and strategies for cardiovascular prevention. Arch. Iran. Med. 2019;22(4):204–210. - PubMed
    1. Consortium G.C.R. Global effect of modifiable risk factors on cardiovascular disease and mortality. N. Engl. J. Med. 2023;389(14):1273–1285. - PMC - PubMed
    1. Roth G.A., Mensah G.A., Fuster V. The global burden of cardiovascular diseases and risks: a compass for global action. 2020;76(25):2980–2981. - PubMed

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