Comparison of Atherosclerotic Cardiovascular Disease Risk Scoring Systems in Bangladeshi Population.

Abstract

Risk stratification is an important initial step for primary prevention of atherosclerotic cardiovascular diseases. There are a number of scoring systems for this purpose worldwide. We tried to evaluate two most updated scoring systems. To assess which one is the better for Bangladeshi population residing in Bangladesh. This cross-sectional study was conducted in a secondary and a tertiary care hospital in Bangladesh from January 2019 to June 2019. Total 274 patients were included in the study. They were evaluated using ASCVD scoring system and QRISK3 scoring system for the risk of atherosclerotic cardiovascular event (myocardial infarction and/or stroke) in next 10 years. Average age of the patients was 57.1±12.8 years and 192 of them were male and 92 of them were female. Half (50.4%) of the patients were smoker, half (51.1%) of them were hypertensive, 45.6% of them were diabetic, 29.6% of them had family history of premature atherosclerotic cardiovascular diseases and 27.0% of them were overweight or obese. According to ASCVD scoring 36.5% patients were at high risk, 32.5% at intermediate risk, 16.4% at low risk of cardiovascular events in next 10 years and risk evaluation was not possible in 14.6% patients. According to QRISK3 scoring method 55.5% are at high risk, 20.8% at intermediate risk, 16.0% at low risk of cardiovascular events and evaluation was not possible in 7.7% patients. Predictive value of QRISK3 scoring system is better to detect more patients who are at high risk for atherosclerotic cardiovascular events in next 10 years. QRISK3 can also evaluate the patients at a younger age. At present QRISK3 is better system to evaluate cardiovascular risk in Bangladeshi population. We need further study to evaluate its role in the form of clinical efficacy and cost effectiveness.