CONCORDANCE BETWEEN CARDIOVASCULAR RISK MODELS AND THE GAP BETWEEN STATIN INDICATION AND PRESCRIPTION IN PRIMARY CARE PATIENTS IN PERU

Fuentes-Yufra A.; Ingar-Choque L.F.; Franco-Espinoza A.E.; Miranda-Chavez B.; Inquilla Castillo M.; Copaja-Corzo C. · Revista de la Facultad de Medicina Humana (2026) · DOI: 10.25176/rfmh.v26i1.7715

Resumen

Introduction: Accurate cardiovascular risk (CVR) estimation is required in Peru. Objective: To compare the concordance between CVR calculators in patients from a chronic disease program in Peru and to analyze differences in statin indication and prescription according to each model. Methods: An analytical cross-sectional study was conducted in a primary care center in Tacna using the corrected Framingham Risk Score for Cardiovascular Disease (FRSCVD), Predicting Risk of Cardiovascular Disease EVENTS (PREVENT), Systematic COronary Risk Evaluation 2 (SCORE-2), and the PAHO/WHO calculator. Concordance was assessed using the Bland-Altman method and the kappa index. Additionally, the proportion of patients eligible for statin therapy according to each calculator was analyzed. Results: A total of 424 patients were evaluated, with a median age of 66 years; 87.7% had hypertension and 55.2% had type 2 diabetes mellitus. SCORE-2 showed the highest concordance with the corrected FRSCVD, with kappa=0.61 and 95% CI=0.46 to 0.76. The PAHO/WHO and PREVENT calculators showed lower concordance, with kappa=0.43 and 95% CI=0.33 to 0.54, and kappa=0.28 and 95% CI=0.18 to 0.38, respectively. Therefore, a significant therapeutic gap was identified, as between 47.1% and 72.9% of patients with a clinical indication for statin therapy were not receiving treatment. Conclusions: SCORE-2 showed the highest concordance with the national standard, the corrected FRSCVD, whereas PREVENT showed the greatest divergence. The variability between models and the underuse of statins highlight the need to standardize and validate CVR assessment in Peruvian primary care. Article published by the Revista de la Facultad de Medicina Humana of Universidad Ricardo Palma. It is an open access article, distributed under the terms of the Creative Commons License: Creative Commons Attribution 4.0 International, CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/non-commercial use, distribution and reproduction in any medium, provided that the original work is duly cited.

Instituciones: Universidad San Ignacio de Loyola; Universidad Privada de Tacna