Comparison between Cerebrovascular Function Score and Modified Framingham Stroke Profile for stroke prediction
Objective To compare and evaluate the Cerebrovascular Function Score(CVFS)and Modified Framingham Stroke Profile(MFSP)for assessing 10 year risk of first stroke,and provide the reference for the selection of the first stroke risk assessment tools.Methods In April 2003,the cluster sampling method was used to establish a cohort for stroke risk factors including 7 489 subjects(≥40 years old)from a community in Fengxian District of Shanghai.The baseline investigation for common stroke risk factors was performed with the indexes of cerebrovascular function and electrocardiogram(ECG).The incidence of stroke was followed up year by year,the first stroke served as the end point,and the follow-up was until December 31,2014.The efficacy of CVFS and MFSP in predicting 10-year first-episode stroke risk was evaluated and compared.The trendx2 test was used to analyze the data.The used software was SPSS 17.0.Results Mean follow-up time of 7 489 subjects was(10.6±1.5)years.During the follow-up period,225 cases suffered from the first stroke.With the MFSP score increase and the CVFS reduction,the risk of first stroke in males and females significantly increased(P＜0.01).MFSP predicted that the probability of first stroke in males was significantly higher than actual stroke incidence,the predicted sensitivity,specificity,and area under the receiver operating characteristic(ROC)curve(AUC)were 97.0％,17.6％,and 0.757,respectively.The probability of female MFSP score＜15 predicting first stroke was close to the actual incidence,but the probability of female MFSP score≥15 predicting first stroke was significantly higher than actual stroke incidence,the predicted sensitivity,specificity,and AUC were 58.1％,78.3％,and 0.769,respectively.With the exception of males 31-40 and 0-10,the probability of CVFS predicting first stroke in males and females was close to the actual incidence.The sensitivity,specificity,and AUC for predicting first-episode stroke in males were 56.4％,76.4％,and 0.682,respectively.The sensitivity,specificity,and AUC for predicting first-episode stroke in females were 60.5％,70.9％,and 0.709,respectively.The concordance rate between CVFS and MFSP in predicting male with high risk of stroke was 39.5％,with a Kappa value of 0.09.The concordance rate between CVFS and MFSP in predicting female with high risk of stroke was 74.1％,with a Kappa value of 0.34.Conclusion The first stroke risk predicted by CVFS in male and female was close to the actual incidence.MFSP obviously overestimated the first stroke risk in Chinese males and Chinese females with high MFSP score.
StrokeRisk estimationCerebrovascular Function ScoreModified Framingham Stroke Profile
NETL
NSTL
万方数据
