Predictive validity of the risk SCORE model in a Mediterranean population with dyslipidemia

Area of Science:

• Cardiology
• Preventive Medicine
• Risk Assessment

Background:

• Cardiovascular disease prevention relies on risk assessment, often using the SCORE scale.
• Dyslipidemia is a key factor in cardiovascular risk.
• The SCORE scale's utility in untreated dyslipidemia requires evaluation.

Purpose of the Study:

• To assess the predictive value of the SCORE scale for cardiovascular events and all-cause mortality.
• To evaluate the clinical utility of the SCORE scale in patients with dyslipidemia.
• To determine the impact of comorbidities on SCORE scale accuracy.

Main Methods:

• Analysis of the ESCARVAL-RISK cohort including patients with dyslipidemia and no lipid-lowering treatment.
• Calculation of cardiovascular risk using the SCORE scale.
• Five-year follow-up recording cardiovascular events and all-cause mortality.
• Assessment of sensitivity, specificity, and predictive values at different cut-off points.
• Evaluation of risk factors' influence on diagnostic accuracy.

Main Results:

• In 18,853 patients, the 5% SCORE threshold showed 86% specificity for death and 90% for cardiovascular events, but only 53% sensitivity for death and 32% for events.
• The SCORE scale underestimated risk, classifying 62.8% of event patients and 46.6% of deceased patients as low risk.
• Comorbidities like diabetes, hypertension, and kidney disease reduced predictive accuracy, while metabolic syndrome improved it.

Conclusions:

• The SCORE scale demonstrates limited predictive capability for cardiovascular disease and total mortality in individuals with dyslipidemia.
• The findings suggest a need for caution when applying the SCORE scale in this specific patient population.
• Further research may be needed to refine risk assessment tools for dyslipidemia management.