Developing a Stroke Risk Prediction Model Using Cardiovascular Risk Factors: The Suita Study
Developing a Stroke Risk Prediction Model Using Cardiovascular Risk Factors: The Suita Study
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DOI：
10.1159/000520100
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发表时间：
2021-11-29
影响因子：
2.9
通讯作者：
Koga, Masatoshi
中科院分区：
文献类型：
--
作者：
Arafa, Ahmed;Kokubo, Yoshihiro;Koga, Masatoshi
简介：中风仍然是日本和全世界死亡和残疾的主要原因。建议检测中风高危人群并采取预防措施。本研究旨在利用心血管危险因素在日本城市中开发中风风险预测模型。方法：我们对 6,641 名年龄在 30-79 岁之间、既没有中风病史也没有冠心病史的参与者进行了随访。 Cox 比例风险模型估计了中风发病风险，并根据基线调查中的潜在混杂因素进行了调整。使用接受者操作特征曲线和 Hosmer-Lemeshow 统计数据评估模型的性能。使用推导和验证样本测试风险模型的内部有效性。回归系数用于分数计算。结果：在 17.1 年的中位随访期间，372 名参与者出现中风。包括年龄较大、当前吸烟、血压升高、空腹血糖受损和糖尿病、慢性肾病和心房颤动在内的风险模型预测中风发病率，曲线下面积 = 0.76，拟合优度 p 值 = 0.21。该风险模型被证明是内部有效的（验证样本中拟合优度的 p 值 = 0.64）。在0至26的风险评分中，0-5、6-7、8-9、10-11、12-13、14-15和16-26类别的卒中发生率分别为1.1%、2.1%、5.4%、8.2%、9.0%、13.5%和18.6%。结论：我们为日本城市普通人群开发了一种新的中风风险模型。需要进一步研究以确定该模型的临床实用性。
Introduction: Stroke remains a major cause of death and disability in Japan and worldwide. Detecting individuals at high risk for stroke to apply preventive approaches is recommended. This study aimed to develop a stroke risk prediction model among urban Japanese using cardiovascular risk factors. Methods: We followed 6,641 participants aged 30-79 years with neither a history of stroke nor coronary heart disease. The Cox proportional hazard model estimated the risk of stroke incidence adjusted for potential confounders at the baseline survey. The model's performance was assessed using the receiver operating characteristic curve and the Hosmer-Lemeshow statistics. The internal validity of the risk model was tested using derivation and validation samples. Regression coefficients were used for score calculation. Results: During a median follow-up duration of 17.1 years, 372 participants developed stroke. A risk model including older age, current smoking, increased blood pressure, impaired fasting blood glucose and diabetes, chronic kidney disease, and atrial fibrillation predicted stroke incidence with an area under the curve = 0.76 and p value of the goodness of fit = 0.21. This risk model was shown to be internally valid (p value of the goodness of fit in the validation sample = 0.64). On a risk score from 0 to 26, the incidence of stroke for the categories 0-5, 6-7, 8-9, 10-11, 12-13, 14-15, and 16-26 was 1.1%, 2.1%, 5.4%, 8.2%, 9.0%, 13.5%, and 18.6%, respectively. Conclusion: We developed a new stroke risk model for the urban general population in Japan. Further research to determine the clinical practicality of this model is required.