Predictive validity of cardio- vascular risk assessment score – a cohort study in Bulgaria
General Medicine,2023, 25(1), 9-15.
P. Latev1, R. Dimova2, R. Stoyanova2, D. Keskinova3, G. Tsigarovski1
1 Department of Urology and General Medicine, Faculty of Medicine, Medical University – Plovdiv
2 Department of Health Management and Health Economics, Faculty of Public Health, Medical University – Plovdiv
3 Department of Applied and Institutional Sociology, Faculty of Philosophy and History, University of Plovdiv Paisiy Hilendarski
Abstract. Introduction: Cardiovascular diseases have a huge negative impact not only on public and individual health, but also on the economies of countries around the world. The aim of the present study was to evaluate the predictive validity of SCORE for National Framework Agreement (NFA) and the impact of additional modifying risk factors on the categorization of patients and their cardiovascular risk. Material and methods: A prospective longitudinal study was conducted with retrospective data collection of the SCORE cardiovascular risk. The cohort comprises 1598 patients who met the criteria for cardiovascular disease risk assessment according to the NFA, including 704 (44.1%) women and 894 (55.9%) men. Descriptive statistics, Non-parametric analysis, ROC curve, Logistic regression and Decision tree were used. Data were analyzed using a IBM SPSS Statistics v.21.0 and MedCalc software. Results: According to the distribution of patients by risk groups, the share of patients in the SCORE moderate risk group (≥ 1% < 5%) is the largest, based on the occurrence of atherosclerotic CVD or death. The estimated global absolute risk SCORE is 2.740. The positive predictive value (PPV) of SCORE is 63.16%. Conclusions: For the first time among the Bulgarian population, the diagnostic ability of SCORE (NFA) has been measured with the indicators: sensitivity, specificity, positive and negative predictive value. The measured predictive value (PPV) of SCORE (NFA) was unsatisfactory. The study has found that the modified additional risk factor is excessive fasting glucose – over 6.1 mmol/l.
Key words: cardiovascular risk, SCORE, cardiovascular diseases, risk factors, predictive validity
Address for correspondence: Assoc. Prof. Rositsa Dimova, MD, PhD, е-mail: ros_dimova@yahoo.com