Inclusion of hazardous drinking does not improve the SCORE performance in men from Central and Eastern Europe: the findings from the HAPIEE cohorts

Olga Vikhireva, Ruzena Kubinova, Sofia Malyutina, Andrzej Pająk, Galina Simonova, Martin Bobak, Hynek Pikhart

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Abstract

BACKGROUND: The SCORE (Systematic COronary Risk Evaluation) scale uses conventional risk factors for the prediction of the 10-year risk of fatal atherosclerotic cardiovascular disease (CVD). The high-risk version of SCORE is recommended by the European Society of Cardiology for use in the populations of Central and Eastern Europe and former Soviet Union (CEE/FSU). Given the role of hazardous alcohol consumption as an important determinant of CVD mortality in CEE/FSU men, this study investigated whether adding hazardous drinking characteristics to the high-risk SCORE improves its prognostic performance in contemporary population-based male CEE/FSU cohorts.

METHODS: The HAPIEE (Health, Alcohol, and Psychosocial factors In Eastern Europe) study follows Czech (seven towns), Polish (Krakow), and Russian (Novosibirsk) cohorts from 2002-2005. In HAPIEE men (n = 8,927), 264 atherosclerotic cardiovascular deaths were registered over the median follow-up time of 6.2-8.1 years.

RESULTS: In HAPIEE men, the baseline levels of the high-risk SCORE ≥5% significantly predicted fatal CVD. After controlling for the high-risk SCORE, binge drinking (drinking ≥100 g of ethanol at least once a month) and problem drinking (≥2 positive answers to CAGE questionnaire) were inconsistently associated with fatal CVD. No marked improvement in calibration and discrimination was observed for the high-risk SCORE extended by these hazardous drinking indicators, and all values of integrated discrimination improvement were <0.5%.

CONCLUSIONS: Extending the high-risk SCORE by hazardous drinking parameters failed to improve its prognostic performance across male CEE/FSU population samples. Our findings tentatively support the use of the original high-risk SCORE in male CEE/FSU populations. More research is needed on the potential use of hazardous drinking in cardiovascular risk prediction.

Original languageEnglish
Article number1187
Number of pages8
JournalBMC Public Health
Volume14
DOIs
Publication statusPublished - 20 Nov 2014

Keywords

  • Adult
  • Alcohol Drinking
  • Cardiovascular Diseases
  • Cohort Studies
  • Europe
  • European Continental Ancestry Group
  • Humans
  • Male
  • Middle Aged
  • Risk Assessment
  • Risk Factors
  • Journal Article
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Cardiovascular mortality and risk factors
  • SCORE scale
  • Hazardous drinking
  • Central and Eastern Europe
  • Former Soviet Union

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