New CV risk score more appropriate for UK
A new measure of cardiovascular risk — the QRISK score — may identify high-risk patients in the UK more appropriately than current measures, which tend to over-predict risk, new research suggests (BMJ
Online First, 5 July 2007).
UK researchers analysed data from 1.28 million patients (aged 35 to 74
years) from 318 general practices on the QResearch database to develop
QRISK, taking into account patients’ age, sex and social deprivation.
They validated the score against a cohort of over 610,000 patients from
160 practices, and tested the frequently used Framingham algorithm and
the newer Scottish ASSIGN score against the same cohort.
The Framingham algorithm over-predicted 10-year cardiovascular disease
risk by 35 per cent and ASSIGN by 36 per cent, compared with 0.4 per
cent for QRISK.
Over 6.5 per cent of the cohort would be reclassified from high risk
using the Framingham measure to low using QRISK, the research indicates.
The authors say that QRISK offers more appropriate estimates for the
UK population than the Framingham measure, which was developed during
the peak period of cardiovascular incidence in the US. They say that
QRISK improves the ability to differentiate between high- and low-risk
patients and is “likely to be a more equitable tool to inform management
decisions and help ensure treatments are directed towards those most
likely to benefit”.
However, the authors admit that QRISK has a “home advantage”,
being tested in a similar population to that from which it was derived,
and needs to be further validated in other populations.
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