Turk Kardiyol Dern Ars. Ahead of Print: TKDA-74580 | DOI: 10.5543/tkda.2019.74580
Comparison of the SCORE-Turkey and SCORE for High-risk countries. A cross-sectional analysis of patients presenting with the first episode of acute coronary syndrome
, Duygu Ersan Demirci
Health Sciences University Antalya Training And Research Hospital
This study was a comparison of the Systematic Coronary Risk Estimation for high risk countries (SCORE-HRC) and SCORE-Turkey, aimed at assessing the adequacy of the statin therapy protocol issued by the European Society of Cardiology (ESC) for primary prevention.Keywords:
METHODS A total of 323 patients who experienced their first episode of acute coronary syndrome were included in the study. The risk calculation was determined using age, sex, smoking status, blood pressure, total cholesterol, and High Density Lipoprotein (HDL-C) levels with SCORE. Statin treatment indications were evaluated according to the ESC guidelines (2016).
RESULTS There were significant differences in the statin indication ratios calculated using the SCORE-HRC or SCORE-Turkey (respectively 42.7%, 39.0%, p=0.012). However, with both charts, recommendations were inadequate to commence statin therapy according to the protocol issued by the ESC guidelines.
There was also a significant difference between the two systems in the 10 year cardiovascular (CV) risk estimation (5.09±4.67 with SCORE-HRC, 4.8±4.67 with SCORE-Turkey, p<0.001).
The main difference between the two systems was related to HDL-C. The SCORE-HRC chart was more successful if the patient's HDL-C level was low. As HDL-C levels increased, SCORE-Turkey was better (p<0.001).
7.8% of patients aged 50-59 were in a very high-risk group, there were no patients aged <50 in this group, according to the SCORE-HRC.
CONCLUSION The SCORE-HRC is better than the SCORE-Turkey. It is only appropriate to use the SCORE-Turkey algorithm in a group of patients with high HDL-C levels. The ESC classification with SCORE is inadequate to describe the "very high risk" group.
Risk algorithm, SCORE, Statin therapy
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Corresponding Author: Deniz Demirci, Türkiye