Consider The Evidence: Med/Peds Journal Roundup

February 4, 2006

Risk score for stable angina – Euro heart study

Filed under: BMJ, Cardiology — medblog @ 3:47 pm

BMJ 2/4 – Isnt the Framingham score all we need in predicting cardiovascular outcomes? Apparently not according to this study by Daly et al. in this weeks BMJ.

The framingham risk score was designed for adults who do not have existing cardiac disease. As one can imagine, predicting risk of mortality in a patient with stable angina is a very different animal. A modified FRS exists but does not differentiate between initial and presentig symptoms. This study focuses on creating a mortality risk prediction algorithm based on a european population with stable angina. The proposed scoring system includes prescence of specified comorbitities, diabetic status, angina score, duration of symptoms, ventricular function and EKG changes. Applying the model developed on 75% of the population to the remaining 25% of the population gave a C-statistic for the angina score to predict outcome of 0.74.
Median follow-up length was 13mos. With 3000+ patients, this makes for alot of patient-years but I question how well this data can predict long-term outcomes for patients. With patients now living many years with chronic stable angina, can we apply the data that was gathered over a 12-15 month interval?

Predicting prognosis in stable angina—results from the Euro heart survey of stable angina: prospective observational study

Caroline A Daly, Bianca De Stavola, Jose L Lopez Sendon, Luigi Tavazzi, Eric Boersma, Felicity Clemens, Nicholas Danchin, Francois Delahaye, Anselm Gitt, Desmond Julian, David Mulcahy, Witold Ruzyllo, Kristian Thygesen, Freek Verheugt, Kim M Fox, on behalf of the Euro Heart Survey Investigators

BMJ 2006;332:262-267, doi:10.1136/bmj.38695.605440.AE (published 13 January 2006)




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