[Italian cardiovascular mortality charts of the CUORE Project: are they comparable with the SCORE charts?].

BACKGROUND The CUORE Project, an Italian longitudinal study, and the SCORE Project use similar methodology in data collection of cardiovascular risk factors and events. The aim of this study was to build the CUORE Project risk charts for the assessment of cardiovascular mortality and to compare them with the SCORE charts. METHODS Random population samples enrolled between 1980 and 1990 in Italy were included in the analysis: 7520 men aged 35-69 years without previous cardiovascular events with a mean follow-up period of 10 years for cardiovascular disease. ICD-9 codes of death certificates similar to those of the SCORE Project were considered in the analysis when they appear as first cause of death. Gender stratified Cox proportional hazard models were used to assess cardiovascular mortality, including age, systolic blood pressure, total cholesterol (or total-to-HDL cholesterol ratio) and smoking habit as risk factors. RESULTS Results from gender stratified analysis considering total cholesterol showed that all risk factors included in the cardiovascular mortality Cox model of the CUORE Project were statistically significant. The correspondent area under the ROC curve was 0.822 (95% confidence interval 0.800-0.844) for men. The CUORE Project charts were quite similar to the correspondent charts of the SCORE Project: Lin's concordance coefficient was 0.964. Risk range of non-smoker men was 0-17% for the CUORE cardiovascular mortality risk chart (0-14% for the SCORE chart); risk range of smokers was 0-25% for the CUORE cardiovascular mortality risk chart (0-26% for the SCORE chart). Similar results were observed for the chart with total-to-HDL cholesterol ratio. CONCLUSIONS The comparison between the CUORE and SCORE mortality risk charts demonstrates that the SCORE charts reflect quite well Italian cardiovascular mortality and, correspondingly, Italian cohorts of the CUORE Project are quite representative of European countries with a low risk of cardiovascular mortality.

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