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LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00003812naa a2200421 4500
001oai:DiVA.org:umu-91744
003SwePub
008140815s2014 | |||||||||||000 ||eng|
024a urn:nbn:se:umu:diva-917442 urn
024a https://doi.org/10.1136/heartjnl-2013-3046642 DOI
040 a (SwePub)umu
041 a engb eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
100a Ferrario, Marco M4 aut
2451 0a The contribution of educational class in improving accuracy of cardiovascular risk prediction across European regions :b the MORGAM Project Cohort Component
264 1b BMJ Publishing Group,c 2014
338 a print2 rdacarrier
520 a Objective To assess whether educational class, an index of socioeconomic position, improves the accuracy of the SCORE cardiovascular disease (CVD) risk prediction equation.Methods In a pooled analysis of 68 455 40-64-year-old men and women, free from coronary heart disease at baseline, from 47 prospective population-based cohorts from Nordic countries (Finland, Denmark, Sweden), the UK (Northern Ireland, Scotland), Central Europe (France, Germany, Italy) and Eastern Europe (Lithuania, Poland) and Russia, we assessed improvements in discrimination and in risk classification (net reclassification improvement (NRI)) when education was added to models including the SCORE risk equation.Results The lowest educational class was associated with higher CVD mortality in men (pooled age-adjusted HR=1.64, 95% CI 1.42 to 1.90) and women (HR=1.31, 1.02 to 1.68). In men, the HRs ranged from 1.3 (Central Europe) to 2.1 (Eastern Europe and Russia). After adjustment for the SCORE risk, the association remained statistically significant overall, in the UK and Eastern Europe and Russia. Education significantly improved discrimination in all European regions and classification in Nordic countries (clinical NRI=5.3%) and in Eastern Europe and Russia (NRI=24.7%). In women, after SCORE risk adjustment, the association was not statistically significant, but the reduced number of deaths plays a major role, and the addition of education led to improvements in discrimination and classification in the Nordic countries only.Conclusions We recommend the inclusion of education in SCORE CVD risk equation in men, particularly in Nordic and East European countries, to improve social equity in primary prevention. Weaker evidence for women warrants the need for further investigations.
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Cardiac and Cardiovascular Systems0 (SwePub)302062 hsv//eng
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kardiologi0 (SwePub)302062 hsv//swe
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicin0 (SwePub)3022 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicine0 (SwePub)3022 hsv//eng
653 a ischemic-heart-disease; socioeconomic-status; atherosclerosis risk; 10-year risk; time trends; population; mortality; inequalities; framingham; countries
700a Veronesi, Giovanni4 aut
700a Chambless, Lloyd E4 aut
700a Tunstall-Pedoe, Hugh4 aut
700a Kuulasmaa, Kari4 aut
700a Salomaa, Veikko4 aut
700a Borglykke, Anders4 aut
700a Hart, Nigel4 aut
700a Söderberg, Stefanu Umeå universitet,Kardiologi,The heart centre4 aut0 (Swepub:umu)stso0001
700a Cesana, Giancarlo4 aut
710a Umeå universitetb Kardiologi4 org
773t Heartd : BMJ Publishing Groupg 100:15, s. 1179-1187q 100:15<1179-1187x 1355-6037x 1468-201X
8564 8u http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-91744x lärosäteslänky Till lärosätets (umu) databas
8564 8u https://doi.org/10.1136/heartjnl-2013-304664

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