Revised Framingham Stroke Risk Profile to Reflect Temporal Trends.
Revised Framingham Stroke Risk Profile to Reflect Temporal Trends.
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DOI：
10.1161/circulationaha.115.021275
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发表时间：
2017-03-21
期刊：
影响因子：
37.8
通讯作者：
Seshadri S
中科院分区：
文献类型：
--
作者：
Dufouil C;Beiser A;McLure LA;Wolf PA;Tzourio C;Howard VJ;Westwood AJ;Himali JJ;Sullivan L;Aparicio HJ;Kelly-Hayes M;Ritchie K;Kase CS;Pikula A;Romero JR;D'Agostino RB;Samieri C;Vasan RS;Chêne G;Howard G;Seshadri S
在过去的50年中，经统计学调整的卒中发病率有所下降，这可能是由于各种卒中危险因素的流行和影响发生了变化。更新版本的FSRP可能更好地预测FHS和其他队列中的当前风险。我们比较了标准版（旧版）和修订版（新版）FSRP预测全卒中和缺血性卒中风险的准确性，并在两个外部队列（3个城市（3C）和REGARDS研究）中验证了新的FSRP。我们按照最初的描述计算了旧的FSRP，并使用了一个新的模型，该模型使用了最近的年龄特异性风险因素的患病率和≥ 55岁人群和≥ 65岁子样本的风险比（分别与REGARDS和3C研究的年龄范围相匹配），并比较了这些模型在预测5年和10年卒中风险方面的有效性。在所有三个样本中，新FSRP比旧FSRP更能预测当前卒中风险（新/旧FSRP的校准卡方：在FHS、REGARDS和3C中，男性分别为64.0/12.1、59.4/30.6和20.7/12.5;女性分别为42.5/4.1、115.4/90.3和9.8/6.5）。在REGARDS中，与黑人相比，新的FSRP在白人中是一个更好的预测因子。一个更同期的新FSRP更好地预测了3个大型社区样本中的当前风险，并可作为研究卒中风险的地理和种族差异以及新卒中风险因素的增量诊断效用的基础。
Age-adjusted stroke incidence has decreased over the past 50 years, likely due to changes in the prevalence and impact of various stroke risk factors. An updated version of the Framingham Stroke Risk Profile (FSRP) might better predict current risks in the Framingham Heart Study (FHS) and other cohorts. We compared the accuracy of the standard (Old), and of a revised (New) version of the FSRP in predicting the risk of all-stroke and ischemic stroke, and validated this new FSRP in two external cohorts, the 3 Cities (3C) and REGARDS studies. We computed the old FSRP as originally described, and a new model that used the most recent epoch-specific risk factors' prevalence and hazard-ratios for persons ≥ 55 years and for the subsample ≥ 65 years (to match the age range in REGARDS and 3C studies respectively), and compared the efficacy of these models in predicting 5- and 10-year stroke risks. The new FSRP was a better predictor of current stroke risks in all three samples than the old FSRP (Calibration chi-squares of new/old FSRP: in men 64.0/12.1, 59.4/30.6 and 20.7/12.5; in women 42.5/4.1, 115.4/90.3 and 9.8/6.5 in FHS, REGARDS and 3C, respectively). In the REGARDS, the new FSRP was a better predictor among whites compared to blacks. A more contemporaneous, new FSRP better predicts current risks in 3 large community samples and could serve as the basis for examining geographic and racial differences in stroke risk and the incremental diagnostic utility of novel stroke risk factors.
影响因子：
1.9
作者：
Homayoon N;Ropele S;Hofer E;Schwingenschuh P;Seiler S;Schmidt R
通讯作者：
Schmidt R