{"id":982,"date":"2021-09-20T09:57:39","date_gmt":"2021-09-20T09:57:39","guid":{"rendered":"https:\/\/primastcar.com\/?p=982"},"modified":"2021-10-19T14:58:15","modified_gmt":"2021-10-19T14:58:15","slug":"actualizacion-de-la-escala-predictiva-score-redefiniendo-el-riesgo-cardiovascular-en-europa","status":"publish","type":"post","link":"https:\/\/primastcar.com\/?p=982","title":{"rendered":"ACTUALIZACI\u00d3N DE LA ESCALA PREDICTIVA SCORE: REDEFINIENDO EL RIESGO CARDIOVASCULAR EN EUROPA."},"content":{"rendered":"

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AUTOR: <\/strong>Pablo Fl\u00f3rez Llano. Cardi\u00f3logo en Hospital Valle del Nal\u00f3n.<\/em><\/h4>\n\n\n\n

En el a\u00f1o 2003, se public\u00f3 en la European Heart Journal un sistema predictivo que permit\u00eda estimar a 10 a\u00f1os el riesgo de padecer evento cardiovascular fatal1<\/sup>, como resultado del an\u00e1lisis de 12 estudios de cohortes en poblaci\u00f3n europea con m\u00e1s de doscientos mil pacientes, en lo que se conoci\u00f3 como proyecto SCORE (Systematic COronary Risk Evaluation).<\/strong><\/p>\n\n\n\n

Durante el a\u00f1o 2021, se ha publicado tambi\u00e9n en la European Heart Journal la actualizaci\u00f3n de este modelo predictivo llevada a cabo por el grupo de trabajo SCORE2 con la colaboraci\u00f3n de la Sociedad Europea de Cardiolog\u00eda2<\/sup>.<\/strong><\/p>\n\n\n\n

Estableciendo fronteras en el riesgo cardiovascular<\/strong><\/strong><\/h4>\n\n\n\n

Durante la mediana de seguimiento de 10.7 a\u00f1os, ocurrieron un total de 30.121 eventos cardiovasculares y un total de 33.809 muertes no cardiovasculares. Los resultados se categorizan en funci\u00f3n del colesterol no-HDL en lugar del colesterol total como ocurr\u00eda en el modelo SCORE (figura 2). Adem\u00e1s, este nuevo modelo permite estimar el riesgo de eventos cardiovasculares fatales y no fatales, a diferencia de lo que ocurr\u00eda en el modelo SCORE, que solo permit\u00eda estimar eventos fatales, infraestimando por tanto el alcance verdadero de la enfermedad cardiovascular en cada c\u00e1lculo individual, sobre todo para pacientes j\u00f3venes con menor probabilidad de muerte tras sufrir un evento cardiovascular.<\/strong><\/p>\n\n\n\n

Por otro lado, el modelo original publicado en el a\u00f1o 2003 estaba limitado a pacientes de hasta 69 a\u00f1os. El grupo de trabajo actual, bas\u00e1ndose en los datos publicados de la cohorte noruega (estudio CONOR3<\/sup>) con 28.503 pacientes, ha elaborado un modelo predictivo utilizando un m\u00e9todo similar para pacientes de 70 a 89 a\u00f1os con validaci\u00f3n externa: el SCORE2-OlderPeople4<\/sup> (figura 3).<\/strong><\/p>\n\n\n\n

En el futuro, el modelo SCORE2 podr\u00e1 ser recalibrado teniendo en cuenta la evoluci\u00f3n de la incidencia de enfermedad cardiovascular y el perfil de los factores de riesgo cardiovasculares, permitiendo recalibrar la predicci\u00f3n de riesgo en una poblaci\u00f3n con una evoluci\u00f3n cambiante.<\/strong><\/p>\n\n\n\n

Las claves del proyecto SCORE 2<\/strong><\/strong><\/strong><\/h4>\n\n\n\n
  1. Elaborado a partir de bases de datos de enfermedad cardiovascular contempor\u00e1neas de 13 pa\u00edses distintos.<\/strong><\/li>
  2. Estimaci\u00f3n a 10 a\u00f1os del riesgo de padecer un evento cardiovascular tanto fatal como no fatal, mejorando especialmente la estimaci\u00f3n del riesgo de la poblaci\u00f3n m\u00e1s joven (40-50 a\u00f1os).<\/strong><\/li>
  3. Como limitaci\u00f3n, las principales bases de datos usadas no inclu\u00edan informaci\u00f3n sobre tratamiento previo, historia familiar, etnia, nivel socioecon\u00f3mico o funci\u00f3n renal, lo que puede a obligar a un ajuste cl\u00ednico individual a mayores teniendo en cuenta estos factores.<\/strong><\/li><\/ol>\n\n\n\n
    \"\"
    Figura 1. Reproducido de SCORE2 Working Group. Riesgo bajo: < 100 muertes ECV por 100.000. Riesgo intermedio: 100-150 muertes ECV por 100.000. Riesgo alto: 150-300 muertes ECV por 100.000. Riesgo muy alto: > 300 muertes ECV por 100.000. ECV: Enfermedad CardioVascular<\/span><\/figcaption><\/figure><\/div>\n\n\n\n

    <\/p>\n\n\n\n

    \"\"
    Figura 2. Reproducido de SCORE2 Working Group. Escala de riesgo SCORE2 para la poblaci\u00f3n espa\u00f1ola (bajo riesgo de eventos cardiovasculares).<\/span><\/figcaption><\/figure><\/div>\n\n\n\n

    <\/p>\n\n\n\n

    \"\"
    Figura 3. Reproducido de SCORE2 Working Group. Escala de riesgo SCORE2-OP para la poblaci\u00f3n espa\u00f1ola (bajo riesgo de eventos cardiovasculares) de 70 a\u00f1os en adelante<\/span>.<\/figcaption><\/figure><\/div>\n\n\n\n

    <\/p>\n\n\n

    Referencias:<\/em><\/strong><\/h4>\n

    <\/p>\n

      \n
    1. Conroy R, Py\u00f6r\u00e4l\u00e4 K, Fitzgerald T, Sans S, Menotti A, De Backer G, et al. Estimation of ten-year risk of fatal CVD in Europe: the SCORE Project. Eur Heart J. 2003;24:987-1003.<\/em><\/li>\n
    2. SCORE2 working group and ESC Cardiovascular risk collaboration. SCORE2 risk prediction algorithms: revised models to estimate 10-year risk of cardiovascular disease in Europe. Eur Heart J 2021;42:2439\u20132454.<\/em><\/li>\n
    3. Naess O, S\u00f8gaard AJ, Arnesen E, Beckstr\u00f8m AC, Bjertness E, Engeland A, Hjort PF, Holmen J, Magnus P, Nj\u00f8lstad I, Tell GS, Vatten L, Vollset SE, Aamodt G. Cohort profile: cohort of Norway (CONOR). Int J Epidemiol 2008;37:481\u2013485.<\/em><\/li>\n
    4. SCORE2-OP working group and ESC Cardiovascular risk collaboration. SCORE2-OP risk prediction algorithms: estimating incident cardiovascular event risk in older persons in four geographical risk regions. Eur Heart J 2021;42: 2455\u20132467.<\/em><\/li>\n<\/ol>\n

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      DESCARGAR ART\u00cdCULO<\/strong><\/a><\/div>\n

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      <\/p>","protected":false},"excerpt":{"rendered":"

      AUTOR: Pablo Fl\u00f3rez Llano. Cardi\u00f3logo en Hospital Valle del Nal\u00f3n. En el a\u00f1o 2003, se public\u00f3 en la European Heart Journal un sistema predictivo que permit\u00eda estimar a 10 a\u00f1os el riesgo de padecer evento cardiovascular fatal1, como resultado del an\u00e1lisis de 12 estudios de cohortes en poblaci\u00f3n europea con m\u00e1s de doscientos mil pacientes, en…<\/p>\n

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