Estimation of 10-year risk of fatal cardiovascular disease and coronary heart disease in Iceland with results comparable with those of the Systematic Coronary Risk Evaluation project.

Abstract

BACKGROUND: No data are available on the comparison between an absolute 10-year risk of fatal cardiovascular disease (CVD) and coronary heart disease (CHD) morbidity using the risk assessments of the Systematic Coronary Risk Evaluation (SCORE) project. DESIGN: Data from the prospective Reykjavik Study of 15 782 patients were used to estimate the 10-year risk of fatal CVD and CHD morbidity in Iceland. METHODS: Survival to fatal CVD event was defined as in the SCORE project. Survival to CHD morbidity was defined as having a myocardial infarction, coronary artery bypass graft, or angioplasty. The statistical methodology of SCORE was used. RESULTS: Relative risk in Iceland was comparable with SCORE results but baseline risk was similar to the low-risk version of SCORE, which contradicted previous suggestions for the countries of northern Europe. Correlation between absolute risk of CHD morbidity and risk for fatal CVD was high (r=0.96), resulting in similar ranking of individuals by risk and discriminatory capacity. This is the first published comparison between total fatal CVD risk and CHD morbidity in a population-based cohort using the current risk assessment guidelines of the European Societies on Coronary Prevention. CONCLUSIONS: Risk for fatal CVD in Iceland has the same characteristics as those in a European nation with results varying in accordance with the SCORE project. The risk estimate to be used, CHD morbidity or fatal CVD, is a choice of clinical preference. The data, however, suggest that 5% high-risk threshold of fatal CVD corresponds to a 12% CHD-morbidity risk, which is a significant change from the conventional reference value of 20%.