Welchen Risiko-Score verwenden – ESC-SCORE, Framingham-Score, PROCAM oder CARRISMA?

Abstract

The assessment of overall cardiovascular risk can be performed with one of four different algorithms: the PROCAM algorithm, the ESC-SCORE (Systematic Coronary Risk Evaluation) or the Framingham risk score. The PROCAM-Score and the Framingham risk score emphasize more cholesterol-dependent events, the ESC-SCORE more blood pressure dependent events and CARRISMA utilizes the additional prognostic importance of life style factors on top of the three risk algorithms. Severe obesity (BMI > 35) as well as heavy smoking (40 cig/day) doubles the cardiovascular risk compared to a BMI of 25 or "average" smoking of 15 cig/day respectively. Regular physical activity can reduce the cardiovascular risk up to 40%. If the 10 year risk of myocardial infarction exceeds 20% or of cardiovascular letality 5% respectively an intensified prevention is cost effective and the Number Needed to Treat (NNT) is usually < 200.

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