Abstract

M. MUNOZ, Oscar; I. RODRIGUEZ, Nohora; RUIZ, álvaro  and  RONDON, Martín. Validation of PROCAM and Framingham prediction models as estimators of cardiovascular risk in a Colombian population. Rev. Colomb. Cardiol. [online]. 2014, vol.21, n.4, pp.202-212. ISSN 0120-5633.  https://doi.org/10.1016/j.rccar.2014.02.001.

Aims:To assess whether the Framingham and PROCAM risk functions were applicable to Colombian population. Methods: We performed an external validation study within a historical cohort, including the patients of the primary prevention clinic from the Hospital Militar Central in Bogotá (Colombia). It comprised 1013 patients who were aged 30 to 74 years, free of cardiovascular disease at baseline (1984 to 1996) and followed over 10 years for cardiovascular disease events (coronary death, myocardial infarction, angina pectoris). We compared the number of predicted and observed 10-year cardiovascular disease events (calibration). Finally, we estimated the ability of the risk functions to separate high risk from low risk subjects (discrimination). Results: In patients with low and intermediate risk, the number of cardiovascular disease events predicted by Framingham risk function overestimated those observed (predicted to observed ratio 1.31), with a low ability to separate high risk from low risk subjects (c-statistic 0.65). The PROCAM risk function adjusted by sex had better ability to separate high risk from low risk subjects (c-statistic 0.74) with good calibration (predicted to observed ratio 1.07). We do not have enough high risk patients to extrapolate our results in that population. Conclusion: The Framingham risk function must be used with caution to estimate the absolute cardiovascular disease risk in Colombian low and intermediate risk population without any cardiovascular disease history because of its overestimation and low discrimination abilities. The PROCAM risk function adjusted by sex is a better option to estimate hard cardiovascular disease risk.

Keywords : Epidemiology; Primary prevention; Cardiovascular diseases; Risk of coronary heart disease; Validation studies.

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