Recalibration of the SCORE risk chart for the Russian population
- 239 Downloads
Persisting high levels of cardiovascular mortality in Russia present a specific case among developed countries. Application of cardiovascular risk prediction models holds great potential for primary prevention in this country. Using a unique set of cohort follow-up data from Moscow and Saint Petersburg, this study aims to test and recalibrate the Systematic Coronary Risk Evaluation (SCORE) methods for predicting CVD mortality risks in the general population. The study is based on pooled epidemiological cohort data covering the period 1975–2001. The algorithms from the SCORE project were used for the calibration of the SCORE equation for the Moscow and St. Petersburg populations (SCORE-MoSP). Age-specific 10-year cumulative cardiovascular mortality rates were estimated according to the original SCORE-High and SCORE-Low equations and compared to the estimates based on the recalibrated SCORE-MoSP model and observed CVD mortality rates. Ten-year risk prediction charts for CVD mortality were derived and compared using conventional SCORE-High and recalibrated SCORE-MoSP methods. The original SCORE-High model tends to substantially under-estimate 10-year cardiovascular mortality risk for females. The SCORE-MoSP model provided better results which were closer to the observed rates. For males, both the SCORE-High and SCORE-MoSP provided similar estimates which tend to under-estimate CVD mortality risk at younger ages. These differences are also reflected in the risk prediction charts. Using non-calibrated scoring models for Russia may lead to substantial under-estimation of cardiovascular mortality risk in some groups of individuals. Although the SCORE-MoSP provide better results for females, more complex scoring methods involving a wider range of risk factors are needed.
KeywordsRisk factors Cardiovascular mortality Risk prediction SCORE risk equation Russia
This study was supported by research Grant R 01 AG 026786 from the National Institute of Aging (USA). The funding agency had no role in the study design; in the collection, analysis, and interpretation of the data; in writing the manuscript; or in the decision to submit it for publication.
- 9.Perk J, De Backer G, Gohlke H, et al. European guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur Heart J. 2012;33(13):1635–701.PubMedCrossRefGoogle Scholar
- 10.Vikhireva O, Pajak A, Broda G et al. SCORE performance in Central and Eastern Europe and former Soviet Union: MONICA and HAPIEE results. Eur Heart J ahead of print 20 June 2013. doi: 10.1093/eurheartj/eht189.
- 11.Shkolnikov V, Meslé F, Vallin J. Health crisis in Russia I. Recent trends in life expectancy and causes of death from 1970 to 1993. Popul Engl Sel. 1996;8:123–54.Google Scholar
- 12.Meslé F. Mortality in eastern and western Europe: awidening gap. In: Coleman D, editor. Europe’s population in the 1990s. Oxford: Oxford University Press; 1996. p. 127–43.Google Scholar
- 13.Shkolnikov VM, Andreev EM, Leon DA, et al. Mortality reversal in Russia: the story so far. Hyg Int. 2004;4(4):29–80.Google Scholar
- 15.Shalnova SA, Oganov RG, Deev AD. Otsenka i upravlenyesumarnymriskomserdechno-sosudistykhzabolevanii u naselenya Rossii. Cardiovasc Ther Prev. 2004;3(4):4–11.Google Scholar
- 16.Shalnova SA, Vikhireva OV. Otsenkasumarnogoriskaserdechno-sosudistyhzabolevanii. Ration Pharmacother Cardiol. 2005;3:54–6.Google Scholar
- 18.WHO MONICA Project. MONICA Manual. 1999. http://www.ktl.fi/publications/monica/manual/index.htm. Accessed 05 May 2013.
- 19.Shigan EE. Dinamikaepidemiologicheskoisituacii v otnosheniismertnostiotosnovnyhkhronicheskihneinfekcionnykhzabolevaniisredimuzhskogonaselenya 20-69 let. Za 10-letniy period – s 1979-1980 po 1989–1991 g. (podannymepidemiologicheskihissledovanyi v g. Moskve) (Disertatsya). Moscow: State Research Center for Preventive Medicine, Ministry of Health of the Russian Federation; 1993.Google Scholar
- 20.Shkolnikov VM, Deev AD, Kravdal Ø, Valkonen T. Educational differentials in male mortality in Russia and northern Europe: a comparison of an epidemiological cohort from Moscow and St. Petersburg with the male populations of Helsinki and Oslo. Demogr Res. 2004;10(1):1–26.Google Scholar
- 24.Meslé F, Shkolnikov VM, Hertrich V, Vallin J. Tendances récentes de la mortalité par cause en Russie, 1965–1994: la crise sanitaire dans les pays de l’ex-URSS. Paris: INED; 1996.Google Scholar
- 25.Bedniy MS, Ivakina VN, Dmitriev VI, Nikolski AV. Analizstepenitochnostidiagnostikizabolevanii i prichinsmerti. Information Bulletin of the Russian Federation Ministry of Health; 1981.Google Scholar
- 26.Bedniy MS, Ivakina VN, Dmitriev VI, Nikolski AV. Analizmediko-demograficheskihpokazatelei. Moscow: Respublikanskaya NIL MeditsinskoyDemografii; 1980.Google Scholar