Reclassification of the Framingham risk score and its agreement with other three calculations

Abstract

Objective: To investigate the concordance between the modified Framingham score using the ankle-brachial index and the high-sensitivity C-reactive protein with the other scores. Materials and method: Cross-sectional study nested with a cohort, with elderly population, from January to March, 2018. The population characterization was presented as mean, median, absolute and relative frequencies according to degree of normality. The Kappa concordance of the modified Framingham score was calculated with the Framingham score itself, with the Systematic Coronary Risk Evaluation (Score) and with the Prospective Cardiovascular Munster (Procam). Results: The modified Framingham score shows moderate Kappa concordance with the Framingham score and the Score (p < 0.001), but weak with Procam. The ultra-sensitive C-reactive protein presented more reclassification of individuals among risk strata than the ankle-brachial index. Conclusions: The Framingham score modified with the Framingham score itself, and then with the Score obtained a higher proportion of concordant cases in the high-risk stratum. High-sensitivity C-reactive protein and the ankle-brachial index modify cardiovascular risk as emerging factors to provide an accurate risk stratification and to infer better management of the therapy. Thus, the Framingham score with its reclassification is the best screening tool for cardiovascular risk.