The pertinency of various calculators in prediction of cardiac risk – an Indian scenario

Introduction: Cardiovascular disease is the commonest cause of sudden death and its risk is increasing world over. There are several cardiac risk analysis scores and calculators such as the Framingham Risk score- coronary heart disease (FRS-CHD), Framingham Risk Score- Cardiovascular Disease Risk, (FRS-CVD), Joint British Society risk calculator 3 (JBS3), American College of Cardiology/American Heart Association and others but there are no studies to determine which is best for our population. Hence this study aims to compare 3 of the most established calculators and look for applicability to our settings in south India. Materials: A cross-sectional study was done using, The Framingham heart study calculator, QRISK®3-2018 cardiovascular disease risk calculator and the Mayo clinic heart disease risk calculator which were used to evaluate the risks in the study population and then compared. Results: Both QRISK and Framingham calculators taken together give a reliability coefficient of Cronbach’s Alpha = 9.55 that is a 96% reliability hence either can be suggested for use in practice. However, the Framingham can give the risk using just anthropometry, or lipid profile which give different values each and can be a reason for minimal variation. But as the Framingham can give the risk using just anthropometry, or just by using lipid profile this is helpful to reduce the numbers of tests being done and also help quicker analysis. Conclusion: The estimation of the cardiac risk using either the QRISK3 or Framingham calculators must become standard procedure in hospital records, since they are applicable to the south Indian population, as seen in our study. Regular screening and increasing the awareness in imperative as only then can modifiable risk factors be used to try and reduce the risk of a cardiac event. The main motto of such a study was to improve community health care.