International Journal of Cardiovascular Sciences. 13/mar/2025;38:e20230159.
Agreement Between Cardiovascular Risk Stratification Instruments in Geriatric Patients
Maria Paula Ronchi Colombo
, Luana Ghisi Ubiali
, Gabriela Serafim Keller
, Luisa Rosler Grings
, Roberto Gabriel Salvaro
Abstract
Background:
Elderly patients are more likely to develop cardiovascular events. Tools for risk stratification serve as support to prevent threats of events and assess eligibility for statin use.
Objectives:
Evaluate the degree of concordance between tools for cardiovascular risk stratification in elderly patients.
Methods:
Cross-sectional, observational, descriptive, analytical study, with secondary data from 124 medical records of patients treated at a geriatric outpatient clinic in the South of Santa Catarina, Brazil. Variables present in the cardiovascular disease (CVD) risk stratification instrument were analyzed. Subsequently, the tools were compared. Inferential analysis was carried out with a 95% confidence interval and significance level α = 0.05. The Shapiro-Wilk and Kolmogorov-Smirnov tests were applied to determine the normal distribution of quantitative variables. The degree of concordance between CVD risk stratification instruments was calculated using the kappa concordance index.
Results:
Most patients were classified as high risk. There was a discrepancy regarding SCORE2/SCORE-OP, as it proved to be highly sensitive to the threat of cardiovascular events (99.2% of patients were high risk). These outcomes relate to the fact that the sample was geriatric patients, with age being an independent risk factor. There was a significant p value (p < 0.001) when comparing ACC/AHA tools and the Framingham Score.
Conclusion:
CVD risk estimate and its comparison in different stratification tools presented an important concordance between AHA tools and the Framingham score. However, when assessing SCORE2/SCORE-OP, lower concordance was observed.
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