Validation of Risk Prediction Models for Atherosclerotic Cardiovascular Disease in a Prospective Korean Community-Based Cohort
Validation of Risk Prediction Models for Atherosclerotic Cardiovascular Disease in a Prospective Korean Community-Based Cohort
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DOI：
10.4093/dmj.2019.0061
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发表时间：
2020-06-01
影响因子：
5.9
通讯作者：
Lee, Moon-Kyu
中科院分区：
文献类型：
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作者：
Bae, Jae Hyun;Moon, Min Kyong;Lee, Moon-Kyu
背景资料：研究2013年美国心脏病学会/美国心脏协会合并队列方程（PCE）在韩国一个大型、前瞻性、基于社区的队列中的表现，并将其与FRS-CVD和韩国风险预测模型（KRPM）进行比较。在韩国基因组和流行病学研究（KOGES）-安山和Ansung研究中，我们评估了PCE对非西班牙裔白人（PCE-WH）和非裔美国人（PCE-AA）的校准和区分，并将其预测能力与FRS进行了比较。结果：本研究包括7，932人（3，778名男性和4，154名女性）。PCE-WH和PCE-AA中度高估了男性动脉粥样硬化性心血管疾病（ASCVD）的风险（分别为6%和13%），但低估了女性的风险（分别为-49%和-25%）。FRS-CVD高估了男性的ASCVD风险（91%），但为女性提供了良好的风险预测（3%）。KRPM低估了男性（-31%）和女性（-31%）的ASCVD风险。所有的风险预测模型在男性（C-统计量0.730至0.735）和女性（C-统计量0.726至0.732）中均显示出良好的区分度。重新校准的PCE使用的数据从KOGES-Ansan和Ansung的研究大大提高了预测准确性，在MEMBER.CONCLUSION：在KOGES-Ansan和Ansung的研究，PCE高估ASCVD的风险为男性和低估的风险为女性。PCE-WH和FRS-CVD分别为男性和女性ASCVD提供了准确的预测。
Background: To investigate the performance of the 2013 American College of Cardiology/American Heart Association Pooled Cohort Equations (PCE) in a large, prospective, community-based cohort in Korea and to compare it with that of the Framingham Global Cardiovascular Disease Risk Score (FRS-CVD) and the Korean Risk Prediction Model (KRPM).Methods: In the Korean Genome and Epidemiology Study (KOGES)-Ansan and Ansung study, we evaluated calibration and discrimination of the PCE for non-Hispanic whites (PCE-WH) and for African Americans (PCE-AA) and compared their predictive abilities with the FRS-CVD and the KRPM.Results: The present study included 7,932 individuals (3,778 men and 4,154 women). The PCE-WH and PCE-AA moderately overestimated the risk of atherosclerotic cardiovascular disease (ASCVD) for men (6% and 13%, respectively) but underestimated the risk for women (-49% and -25%, respectively). The FRS-CVD overestimated ASCVD risk for men (91%) but provided a good risk prediction for women (3%). The KRPM underestimated ASCVD risk for men (-31%) and women (-31%). All the risk prediction models showed good discrimination in both men (C-statistic 0.730 to 0.735) and women (C-statistic 0.726 to 0.732). Recalibration of the PCE using data from the KOGES-Ansan and Ansung study substantially improved the predictive accuracy in men.Conclusion: In the KOGES-Ansan and Ansung study, the PCE overestimated ASCVD risk for men and underestimated the risk for women. The PCE-WH and the FRS-CVD provided an accurate prediction of ASCVD in men and women, respectively.