Axel C P Diederichsen1, Amir-Abbas Mahabadi2, Oke Gerke3, Nils Lehmann4, Niels P Sand5, Susanne Moebus4, Jess Lambrechtsen6, Hagen Kälsch2, Jesper M Jensen7, Karl-Heinz Jöckel4, Hans Mickley8, Raimund Erbel2. 1. Department of Cardiology, Odense University Hospital, Denmark. Electronic address: axel.diederichsen@rsyd.dk. 2. Department of Cardiology, West-German Heart Centre, University Hospital of Essen, Germany. 3. Department of Nuclear Medicine, Odense University Hospital, Denmark; Centre of Health Economics Research, University of Southern Denmark, Denmark. 4. Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Germany. 5. Department of Cardiology, Sydvestjysk Hospital, Denmark. 6. Department of Cardiology, Svendborg Hospital, Denmark. 7. Department of Cardiology, Aarhus University Hospital-Skejby, Denmark. 8. Department of Cardiology, Odense University Hospital, Denmark.
Abstract
OBJECTIVES: The European HeartScore has traditionally differentiated between low and high-risk countries. Until 2012 Germany and Denmark were considered to be high-risk countries but have now been defined as low-risk countries. In this survey we aim to address the consequences of this downgrading. METHODS: A screening of 3932 randomly selected (mean age 56 years, 46% male) individuals from Germany and Denmark free of cardiovascular disease was performed. Traditional risk factors were determined, and the HeartScore was measured using both the low-risk and the high-risk country models. A non-contrast Cardiac-CT scan was performed to detect coronary artery calcification (CAC). RESULTS: Agreement of HeartScore risk groups with CAC groups was poor, but higher when applying the algorithm for the low-risk compared to the high-risk country model (agreement rate: 77% versus 63%, and weighted Kappa: 0.22 versus 0.15). However, the number of subjects with severe coronary calcification (CAC score ≥400) increased in the low and intermediate HeartScore risk group from 78 to 147 participants (from 2.7 % to 4.2 %, p = 0.001), when estimating the risk based on the algorithm for low-risk countries. CONCLUSION: As a consequence of the reclassification of Germany and Denmark as low-risk countries more people with severe atherosclerosis will be classified as having a low or intermediate risk of fatal cardiovascular disease.
OBJECTIVES: The European HeartScore has traditionally differentiated between low and high-risk countries. Until 2012 Germany and Denmark were considered to be high-risk countries but have now been defined as low-risk countries. In this survey we aim to address the consequences of this downgrading. METHODS: A screening of 3932 randomly selected (mean age 56 years, 46% male) individuals from Germany and Denmark free of cardiovascular disease was performed. Traditional risk factors were determined, and the HeartScore was measured using both the low-risk and the high-risk country models. A non-contrast Cardiac-CT scan was performed to detect coronary artery calcification (CAC). RESULTS: Agreement of HeartScore risk groups with CAC groups was poor, but higher when applying the algorithm for the low-risk compared to the high-risk country model (agreement rate: 77% versus 63%, and weighted Kappa: 0.22 versus 0.15). However, the number of subjects with severe coronary calcification (CAC score ≥400) increased in the low and intermediate HeartScore risk group from 78 to 147 participants (from 2.7 % to 4.2 %, p = 0.001), when estimating the risk based on the algorithm for low-risk countries. CONCLUSION: As a consequence of the reclassification of Germany and Denmark as low-risk countries more people with severe atherosclerosis will be classified as having a low or intermediate risk of fatal cardiovascular disease.
Authors: Hussain A Isma'eel; George E Sakr; Mohamad M Almedawar; Jihan Fathallah; Torkom Garabedian; Savo Bou Zein Eddine; Lara Nasreddine; Imad H Elhajj Journal: Cardiovasc Diagn Ther Date: 2015-06