Abstract:
Background::Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in Brazil, and primary prevention care may be guided by risk stratification tools. The Framingham (FRS) and QRISK-2 (QRS) risk scores estimate 10-year overall cardiovascular risk in asymptomatic individuals, but the instrument of choice may lead to different therapeutic strategies. Objective::To evaluate the degree of agreement between FRS and QRS in 10-year overall cardiovascular risk stratification in disease-free individuals. Methods::Cross-sectional, observational, descriptive and analytical study in a convenience sample of 74 individuals attending the outpatient care service of a university hospital in Brazil between January 2014 and January 2015. After application of FRS and QRS, patients were classified in low/moderate risk (< 20%) or high risk (≥ 20%). Results::The proportion of individuals classified as at high risk was higher in FRS than in QRS (33.7% vs 21.6%). A synergic effect of male gender with systemic arterial hypertension was observed in both tools, and with for geriatric age group in QRS (p < 0.05) in high-risk stratum. The Kappa index was 0.519 (95%CI = 0.386-0.652; p < 0.001) between both instruments. Conclusion::There was a moderate agreement between FRS and QRS in estimating 10-year overall cardiovascular risk. The risk scores used in this study can identify synergism between variables, and their behavior is influenced by the population in which it was derived. It is important to recognize the need for calibrating risk scores for the Brazilian population. Fundamento::A doença cardiovascular (DCV) é a principal causa de morbimortalidade no Brasil, e a prevenção primária pode ser direcionada com ferramentas que estratificam o risco. Os escores de Framingham (ERF) e QRISK-2 (ERQ) estimam o risco cardiovascular (RCV) global em 10 anos em indivíduos assintomáticos, mas a escolha do instrumento pode implicar em terapêuticas distintas. Objetivo::Observar o grau de concordância entre o ERF e o ERQ, na estratificação do risco cardiovascular global em 10 anos, nos indivíduos livres da doença. Métodos::Estudo transversal, observacional, descritivo e analítico, com uma amostra de conveniência de 74 indivíduos, atendidos em um ambulatório de ensino de um hospital universitário brasileiro, no sul do país, de janeiro de 2014 a janeiro de 2015. O ERF e o ERQ foram aplicados nos pacientes, que foram classificados em baixo/moderado (< 20%) ou alto risco (≥ 20%). Resultados::A proporção de indivíduos classificados no estrato de alto risco foi superior no ERF que no ERQ (33,7% vs 21,6%), sendo identificado efeito sinérgico do gênero masculino com hipertensão arterial sistêmica nas duas ferramentas, e com faixa etária geriátrica no ERQ (p < 0,05) nesse estrato de risco. O índice de concordância Kappa entre os dois escores foi igual a 0,519 (IC95% = 0,386-0,652; p < 0,001). Conclusão::Houve concordância moderada entre o ERF e o ERQ, na estimativa de RCV global em 10 anos. Os escores utilizados podem identificar sinergismo entre as variáveis, e têm comportamento influenciado pela população na qual foram originados. É importante reconhecer a necessidade de escores calibrados para a população brasileira.
journal_name
Arq Bras Cardioljournal_title
Arquivos brasileiros de cardiologiaauthors
Garcia GT,Stamm AMNF,Rosa AC,Marasciulo AC,Marasciulo RC,Battistella C,Remor AACdoi
10.5935/abc.20170057subject
Has Abstractpub_date
2017-05-01 00:00:00pages
427-435issue
5eissn
0066-782Xissn
1678-4170pii
S0066-782X2017000500427journal_volume
108pub_type
杂志文章abstract::Over the last two decades the results of randomized clinical studies, which are powerful aids for correctly assessing therapeutical strategies, have consolidated cardiological practice. In addition, scientifically interesting hypotheses have been generated through the results of epidemiological studies. Properly condu...
journal_title:Arquivos brasileiros de cardiologia
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abstract::Growth hormone (GH), the main regulator for post-natal growth, has important metabolic actions on different tissues, similar or opposite to insulin like growth factor I (IGF-I), mainly produced by the liver after the binding of GH to its receptor. Experiments with animal models indicate an important role of GH on insu...
journal_title:Arquivos brasileiros de cardiologia
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abstract:BACKGROUND:There is few data evaluating the prevalence and influence of adverse psychological characteristics on the prognosis of individuals submitted to percutaneous coronary interventions. No study has addressed this issue in Brazil. OBJECTIVE:To investigate the prevalence of depression, anxiety, psychological stre...
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abstract:BACKGROUND:Electrocardiographically-detected left ventricular hypertrophy (LVH) is a strong predictor of cardiovascular morbidity and mortality. OBJECTIVE:To assess the performance of the Sokolow-Lyon-Rappaport (SLR) and Cornell voltage criteria in a population sample regarding the diagnosis of LVH on echocardiogram (...
journal_title:Arquivos brasileiros de cardiologia
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abstract::A 19-years-old female with a primary right atrial angiosarcoma partially obstructing the tricuspid valve, developed severe hypoxemia due to right-to-left shunting through a patient foramen ovale. This is the first report of such clinical situation with this type of tumor. A complete resection of the tumor was attempte...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章,评审
doi:
更新日期:1992-12-01 00:00:00
abstract:BACKGROUND:Heart transplantation is an alternative for individuals with end-stage heart disease. However, episodes of heart rejection (HR) are frequent and increase morbidity and mortality, requiring the use of an accurate non-invasive exam for their diagnosis, since endomyocardial biopsy (EMB) is not a complication-fr...
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abstract:BACKGROUND:The complexity of reentrant circuits related to ventricular tachycardias decreases the success rate of radiofrequency ablation procedures. OBJECTIVE:To evaluate whether the epicardial mapping with multiple electrodes carried out simultaneously with the endocardial mapping helps in ablation procedures of sus...
journal_title:Arquivos brasileiros de cardiologia
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abstract:BACKGROUND:Echocardiography is a useful method for screening and assessing response to cardiac resynchronization therapy (CRT). 3D echocardiography has already established its role in the evaluation of ventricular volumes and ejection fraction (LVEF) with excellent correlation of results when compared with MRI. OBJECT...
journal_title:Arquivos brasileiros de cardiologia
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abstract::Background: Studies have demonstrated the diagnostic accuracy and prognostic value of physical stress echocardiography in coronary artery disease. However, the prediction of mortality and major cardiac events in patients with exercise test positive for myocardial ischemia is limited. Objective: To evaluate the effecti...
journal_title:Arquivos brasileiros de cardiologia
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journal_title:Arquivos brasileiros de cardiologia
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journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章,评审
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journal_title:Arquivos brasileiros de cardiologia
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journal_title:Arquivos brasileiros de cardiologia
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更新日期:1989-10-01 00:00:00
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journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
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journal_title:Arquivos brasileiros de cardiologia
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doi:
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pub_type: 临床试验,杂志文章,多中心研究
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doi:10.1590/s0066-782x2011005000081
更新日期:2011-09-01 00:00:00
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journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:
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journal_title:Arquivos brasileiros de cardiologia
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journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:/S0066-782X2005002400003
更新日期:2005-10-01 00:00:00