Predicción del riesgo cardiovascular y su relación con el síndrome metabólico y los niveles de marcadores serológicos emergentes en vigilancia de la salud de los trabajadores

Abstract

Objectives: To calculate cardiovascular risk according to the American Framingham Coronary Risk Score (FCRS) and the European Systematic Coronary Risk Evaluation (SCORE) methods. To correlate the results with the presence of metabolic syndrome (glycemia, triglyceridemia, cholesterolemia, abdominal circumference and blood pressure) and with serum levels of three emerging biomarkers [ultrasensitive reactive C protein (PCRus), homocysteine (Hcy) and lipoproteín (a) (lp (a)]. Methods: Data were gathered during routine medical surveillance of mostly white collar workers in FREMAP Alcobendas from 2004 to 2006 (n=248). We followed standardized health surveillance protocols as established by the Spanish Health Ministry, along with inclusion of an additional blood sample and measurement of the abdominal circumference. Results: None of the 248 workers included in our sample was classified as having high or very high risk according to FCRS in contrast to 44.8 % according to SCORE. We observed a strong correlation (r=O.78, p<O.OO1) between both predictive methods. We also found associations between both methods and metabolic syndrome (p=0.043), and between the FCRS and PCRus (p=0.021) and Hcy (p=0.036). Conclusions: Our results suggest that the inclusion of risk predictions based on FCRS and/or SCORE could be recommended for the primary prevention of cardiovascular disease, because of their excellent cost-benefit relationship. However, we do not recommend routine measurement of the biological markers included in this study.