Abstract 15997: Pooled Cohort Risk Equations: A Comparison of Their Predictions With Five Other Cardiovascular Risk Scores in Five Peruvian Sites

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Juan Bazo-Alvarez ◽  
Frank Peralta-Alvarez ◽  
Renato Quispe ◽  
Julio Poterico ◽  
Giancarlo Valle ◽  
...  
Keyword(s):  
Risk Score ◽  
Disease Risk ◽  
Heart Association ◽  
Population Based ◽  
Continuous Variable ◽  
World Health ◽  
Risk Scores ◽  
Cvd Risk ◽  
Low Middle Income Countries ◽  
Predicted Risk

Introduction: Cardiovascular disease (CVD) risk scores are used to estimate an individual’s risk of developing a disease or death from a cardiovascular event. Recently, the American College of Cardiology/American Heart Association (ACC/AHA) introduced the Pooled Cohort risk equations (ACC/AHA model). It is important to know how comparable CVD risk predictions are in low-middle income countries (LMIC). Hypothesis: ACC/AHA model has a poor concordance with any other CVD risk score. Methods: We used secondary data from two Peruvian, age and sex-matched, population-based studies across five geographical sites. The ACC/AHA model was compared to five other CVD risk prediction tools: two versions of the Framingham Risk Score (FRS-Lipids and FRS-BMI), Reynolds Risk Score (RRS), four versions of the Systematic Coronary Risk Evaluation (SCORE 1-4), World Health Organization risk chart (WHO), and Lancet Chronic Disease risk chart (LCD). We calculated predicted risk as a continuous variable and used Lin’s concordance correlation coefficient (CCC). We also compared the high predicted risk prevalence between all the scores using the cut-off levels suggested by each score’s guidelines. Results: We included 2183 subjects in the risk scores age range of 45-65 years (mean age 54.3 (SD±5.6) years). CCC agreement values found in this study were generally poor. The highest concordance was observed between the ACC/AHA model and the risk scores derived from the Framingham Study (40% with FRS-BMI and 44% with FRS-Lipids). ACC/AHA model depicted the highest proportion of people with predicted high-risk of 10-year CVD, at 29.0% (95%CI 26.9-31.0%) and the same tendency was observed in all study sites. Conclusions: In Peruvian population-based samples, agreement between ACC/AHA model and five other CVD risk scores was generally poor. There is an urgent need to use an appropriate risk score for CVD in LMIC. In an ideal scenario, it would be significant to have a proper CVD risk score for LMIC.

scholarly journals Developing an Internally Validated Veterans Affairs Women Cardiovascular Disease Risk Score Using Veterans Affairs National Electronic Health Records

2021 ◽  
Vol 10 (5) ◽  
Author(s):  
Haekyung Jeon‐Slaughter ◽  
Xiaofei Chen ◽  
Shirling Tsai ◽  
Bala Ramanan ◽  
Ramin Ebrahimi
Keyword(s):  
Cardiovascular Disease ◽  
Risk Score ◽  
American Heart Association ◽  
American Heart ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Heart Association ◽  
Veterans Affairs ◽  
Cvd Risk ◽  
Classification Index

Background The current American College of Cardiology/American Heart Association women cardiovascular disease (CVD) risk score suboptimally estimates CVD risk for young and minority women in the military. The current study developed an internally validated CVD risk score for women military service members and veterans using the Veterans Affairs (VA) national electronic health records data. Methods and Results The study cohort included 69 574 White, Black, and Hispanic women service members and veterans aged 30 to 79 years in 2007 treated in the VA Health Care System between January 1, 2007 and December 31, 2017 (henceforth, VA women). Stratified by race and ethnicity, the new VA women CVD risk model estimated risk coefficients and 10‐year CVD risk using a time‐variant covariate Cox model. Harrell C‐statistics, calibration plots, and net classification index were used to assess accuracy and prognostic performance of the new VA women CVD risk model. The new internally validated VA women CVD risk score performed better in predicting VA women 10‐year atherosclerosis cardiovascular disease risk than the pooled cohort American College of Cardiology/American Heart Association risk score in both accuracy (White Harrell C‐statistics, 70% versus 61%; Black, 68% versus 63%) and prognostic performance (White net classification index, 0.31; 95% CI, 0.26–0.33; Black net classification index, 0.06; 95% CI, 0.03–0.09). Conclusions The proposed VA women CVD risk score improves accuracy of the existing American College of Cardiology/American Heart Association CVD risk assessment tool in predicting long‐term CVD risk for VA women, particularly in young and racial/ethnic minority women.

scholarly journals A newly developed and externally validated non-clinical score accurately predicts 10-year cardiovascular disease risk in the general adult population

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Catarina Schiborn ◽  
Tilman Kühn ◽  
Kristin Mühlenbruch ◽  
Olga Kuxhaus ◽  
Cornelia Weikert ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Risk Score ◽  
Prediction Models ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Clinical Score ◽  
Risk Scores ◽  
Clinical Parameters ◽  
Cvd Risk ◽  
Clinical Scores

AbstractInclusion of clinical parameters limits the application of most cardiovascular disease (CVD) prediction models to clinical settings. We developed and externally validated a non-clinical CVD risk score with a clinical extension and compared the performance to established CVD risk scores. We derived the scores predicting CVD (non-fatal and fatal myocardial infarction and stroke) in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam cohort (n = 25,992, cases = 683) using competing risk models and externally validated in EPIC-Heidelberg (n = 23,529, cases = 692). Performance was assessed by C-indices, calibration plots, and expected-to-observed ratios and compared to a non-clinical model, the Pooled Cohort Equation, Framingham CVD Risk Scores (FRS), PROCAM scores, and the Systematic Coronary Risk Evaluation (SCORE). Our non-clinical score included age, gender, waist circumference, smoking, hypertension, type 2 diabetes, CVD family history, and dietary parameters. C-indices consistently indicated good discrimination (EPIC-Potsdam 0.786, EPIC-Heidelberg 0.762) comparable to established clinical scores (thereof highest, FRS: EPIC-Potsdam 0.781, EPIC-Heidelberg 0.764). Additional clinical parameters slightly improved discrimination (EPIC-Potsdam 0.796, EPIC-Heidelberg 0.769). Calibration plots indicated very good calibration with minor overestimation in the highest decile of predicted risk. The developed non-clinical 10-year CVD risk score shows comparable discrimination to established clinical scores, allowing assessment of individual CVD risk in physician-independent settings.

scholarly journals COMPARISON OF A FRAILTY INDEX WITH CARDIOVASCULAR RISK SCORES IN PREDICTING CARDIOVASCULAR DISEASE MORTALITY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S800-S800
Author(s):  
Dustin S Kehler ◽  
Olga Theou ◽  
Kenneth Rockwood
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Risk Score ◽  
Mortality Risk ◽  
Disease Risk ◽  
Frailty Index ◽  
Risk Scores ◽  
Atherosclerotic Cardiovascular Disease ◽  
Cvd Risk ◽  
Cvd Mortality

Abstract We compared the predictive and discriminative ability of frailty with traditional cardiovascular risk scores to estimate 10-year cardiovascular disease (CVD) mortality risk. Individuals aged 20-79 years old from the National Health and Nutrition Examination Survey who were free from CVD were included (n= 32,066). A 33-item frailty index (FI) which excluded CVD and diabetes-related variables was calculated. We calculated the Framingham Disease Risk (FDR) Hard Coronary Heart Disease and General CVD risk scores, the American Heart Association/American College of Cardiology (AHA/ACC) atherosclerotic cardiovascular disease risk equation, and the European Systematic Coronary Risk Estimation tool. A total of 322 individuals died (1.0%) from CVD. There was a low correlation between the FI and CVD risk scores (spearman’s r= 0.19-0.33; p<0.0001) and a weak to strong correlation between CVD risk scores (spearman’s r=0.19-0.88; p<0.0001). The competing-risks hazard ratio for CVD mortality for every 1% increase in the FI was 1.040 (95% CI: 1.032-1.048; p<0.0001) in an age and sex-adjusted model. The FI was independently predictive of CVD mortality when the other CVD risk scores were added to the model. The area under the receiving operating characteristic (ROC) curve was 0.800 (95% CI: 0.789-0.808; p<0.0001) for the FI. ROC values for the CVD risk scores ranged from 0.710 (95% CI: 0.700-0.721; p<0.0001) for the AHA/ACC risk score to 0.779 (95% CI: 0.770-0.789; p<0.0001) for the FDR General CVD risk score. An FI calculated with non-CVD and diabetes variables can predict 10-year CVD mortality risk independently of traditional CVD risk scores.

scholarly journals Agreement between Framingham, IraPEN and non-laboratory WHO-EMR risk score calculators for cardiovascular risk prediction in a large Iranian population

2019 ◽  
Vol 12 (1) ◽  
pp. 20-26
Author(s):  
Mohsen Mirzaei ◽  
Masoud Mirzaei
Keyword(s):  
High Risk ◽  
Risk Score ◽  
Communicable Disease ◽  
Eastern Mediterranean ◽  
World Health ◽  
Risk Scores ◽  
Health Study ◽  
Kappa Statistics ◽  
Paired Data ◽  
Cvd Risk

Introduction: Estimation of the risk of cardiovascular diseases (CVD), may lead to prophylactic therapies. This study aims to compare and evaluate the agreement between CVD prediction of Iran Package of Essential Non-communicable Disease (IraPEN) and Framingham risk score (FRS).<br /> Methods: All 40-79 years old participants in the Yazd Health Study who did not have a history of CVD were included. The 10-years risk of CVD was estimated by the laboratory (IraPEN), non-laboratory WHO-EMR B and FRS. The risk was classified into low, moderate and high-risk groups. Cohen’s weighted kappa statistics were used to assess agreement between tools. To assess discrepancies McNemar’s χ2 test for paired data was used. P values < 0.05 were considered statistically significant.<br /> Results: In total, 2103 participant was included and the risk scores were calculated. Of them, 26.5% were stratified as high risk by FRS, compared with 6.1% by IraPEN. A slight agreement (37.9%) was observed (kappa 0.17, P < 0.0001), in other words. This discrepancy between IraPEN vs. FRS was seen in both sexes (P < 0.0001), although in women the agreement ratio was higher (52.1% vs. 21.3%). The discrepancy between FRS and IraPEN in categorizing people at risk of CVD was 55.5%, (P < 0.0001) but this was not significant between IraPEN and non-laboratory WHO-EMR-B (World Health Organization - Eastern Mediterranean Regional-B group countries) score (P < 0.523; discrepancies, 5.8%).<br /> Conclusion: Our study shows a slight agreement between various CVD risk scores. Thus, reviewing the IraPEN and using alternative tools for the low-risk group should be considered by decision-makers. It is important to use a more reliable score for nation-wide risk assessment.

scholarly journals The Relationship between Cardiovascular Risk Scores and Several Markers of Subclinical Atherosclerosis in an Asymptomatic Population

2021 ◽  
Vol 10 (5) ◽  
pp. 955
Author(s):  
Ovidiu Mitu ◽  
Adrian Crisan ◽  
Simon Redwood ◽  
Ioan-Elian Cazacu-Davidescu ◽  
Ivona Mitu ◽  
...  
Keyword(s):  
Risk Score ◽  
Subclinical Atherosclerosis ◽  
Ankle Brachial Index ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Risk Scores ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Single Center Study ◽  
Asymptomatic Individuals

Background: The current cardiovascular disease (CVD) primary prevention guidelines prioritize risk stratification by using clinical risk scores. However, subclinical atherosclerosis may rest long term undetected. This study aimed to evaluate multiple subclinical atherosclerosis parameters in relation to several CV risk scores in asymptomatic individuals. Methods: A cross-sectional, single-center study included 120 asymptomatic CVD subjects. Four CVD risk scores were computed: SCORE, Framingham, QRISK, and PROCAM. Subclinical atherosclerosis has been determined by carotid intima-media thickness (cIMT), pulse wave velocity (PWV), aortic and brachial augmentation indexes (AIXAo, respectively AIXbr), aortic systolic blood pressure (SBPao), and ankle-brachial index (ABI). Results: The mean age was 52.01 ± 10.73 years. For cIMT—SCORE was more sensitive; for PWV—Framingham score was more sensitive; for AIXbr—QRISK and PROCAM were more sensitive while for AIXao—QRISK presented better results. As for SBPao—SCORE presented more sensitive results. However, ABI did not correlate with any CVD risk score. Conclusions: All four CV risk scores are associated with markers of subclinical atherosclerosis in asymptomatic population, except for ABI, with specific particularities for each CVD risk score. Moreover, we propose specific cut-off values of CV risk scores that may indicate the need for subclinical atherosclerosis assessment.

scholarly journals Limited Utility of Cardiovascular Risk Scores for People Living with HIV in Malawi

2020 ◽  
Author(s):  
Chia Goh ◽  
Henry Mwandumba ◽  
Alicja Rapala ◽  
Willard Tingao ◽  
Irene Sheha ◽  
...  
Keyword(s):  
Risk Score ◽  
Low Income ◽  
Intima Media Thickness ◽  
Risk Groups ◽  
Carotid Intima Media Thickness ◽  
Endothelial Damage ◽  
Risk Scores ◽  
People Living With Hiv ◽  
Cvd Risk ◽  
Living With Hiv

HIV is associated with increased cardiovascular disease (CVD) risk. Despite the high prevalence of HIV in low income subSaharan Africa, there are few data on the assessment of CVD risk in the region. In this study, we aimed to compare the utility of existing CVD risk scores in a cohort of Malawian adults, and assess to what extent they correlate with established markers of endothelial damage: carotid intima media thickness (IMT) and pulse wave velocity (PWV). WHO/ISH, SCORE, FRS, ASCVD, QRISK2 and D:A:D scores were calculated for 279 Malawian adults presenting with HIV and low CD4. Correlation of the calculated 10year CVD risk score with IMT and PWV was assessed using Spearmans rho. The median (IQR) age of patients was 37 (31 to 43) years and 122 (44%) were female. Median (IQR) blood pressure was 120/73mmHg (108/68 to 128/80) and 88 (32%) study participants had a new diagnosis of hypertension. The FRS and QRISK2 scores included the largest number of participants in this cohort (96% and 100% respectively). D:A:D, a risk score specific for people living with HIV, identified more patients in moderate and high risk groups. Although all scores correlated well with physiological markers of endothelial damage, FRS and QRISK2 correlated most closely with both IMT [r2 0.51, p<0.0001 and r2 0.47, p<0.0001 respectively] and PWV [r2 0.47, p<0.0001 and r2 0.5, p<0.0001 respectively]. Larger cohort studies are required to adapt and validate risk prediction scores in this region, so that limited healthcare resources can be effectively targeted.

scholarly journals Development and Validation of a Novel Dementia Risk Score in the UK Biobank Cohort

2021 ◽  
Author(s):  
Melis Anatürk ◽  
Raihaan Patel ◽  
Georgios Georgiopoulos ◽  
Danielle Newby ◽  
Anya Topiwala ◽  
...  
Keyword(s):  
At Risk ◽  
Cardiovascular Risk ◽  
Risk Score ◽  
Disease Risk ◽  
Risk Index ◽  
Risk Scores ◽  
Uk Biobank ◽  
Dementia Risk ◽  
History Of ◽  
The Uk

INTRODUCTION: Current prognostic models of dementia have had limited success in consistently identifying at-risk individuals. We aimed to develop and validate a novel dementia risk score (DRS) using the UK Biobank cohort.METHODS: After randomly dividing the sample into a training (n=166,487, 80%) and test set (n=41,621, 20%), logistic LASSO regression and standard logistic regression were used to develop the UKB-DRS.RESULTS: The score consisted of age, sex, education, apolipoprotein E4 genotype, a history of diabetes, stroke, and depression, and a family history of dementia. The UKB-DRS had good-to-strong discrimination accuracy in the UKB hold-out sample (AUC [95%CI]=0.79 [0.77, 0.82]) and in an external dataset (Whitehall II cohort, AUC [95%CI]=0.83 [0.79,0.87]). The UKB-DRS also significantly outperformed four published risk scores (i.e., Australian National University Alzheimer’s Disease Risk Index (ANU-ADRI), Cardiovascular Risk Factors, Aging, and Dementia score (CAIDE), Dementia Risk Score (DRS), and the Framingham Cardiovascular Risk Score (FRS) across both test sets.CONCLUSION: The UKB-DRS represents a novel easy-to-use tool that could be used for routine care or targeted selection of at-risk individuals into clinical trials.

Abstract TP160: Predicting Bone Fracture After Stroke—The Fracture Risk After Ischemic Stroke (FRAC-Stroke) Score

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Eric E Smith ◽  
Jiming Fang ◽  
Shabbir M Alibhai ◽  
Peter M Cram ◽  
Angela M Cheung ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Fracture Risk ◽  
Risk Score ◽  
Cumulative Incidence ◽  
Population Based ◽  
World Health ◽  
Stroke Severity ◽  
Stroke Patients ◽  
One Year ◽  
Low Trauma Fracture

Background: Risk for low trauma fracture is increased by >30% after ischemic stroke. Additionally, in the IRIS trial pioglitazone therapy prevented ischemic stroke but increased fracture risk. We derived a risk score to predict risk of fracture one year after ischemic stroke. Methods: The Fracture Risk after Ischemic Stroke (FRAC-Stroke) Score was derived in 20,435 ischemic stroke patients from the Ontario Stroke Registry discharged from 2003-2012, using Fine-Gray competing risk regression. Candidate variables were medical conditions included in the validated World Health Organization FRAX risk score complemented by variables related to stroke severity. Registry patients were linked to population-based Ontario health administrative data to identify low trauma fractures (defined as any fracture of the femur, forearm, humerus, pelvis or vertebrae, excluding fractures resulting from trauma, motor vehicle accidents, falls from a height or in people with active cancer). The score was externally validated in 13,698 other ischemic stroke patients in the population-based Ontario stroke audit (2002-2012). Results: Mean age was 72; 42% were women. Low trauma fracture occurred within 1 year of discharge in 741/20435 (3.6%); cumulative incidence increased linearly throughout follow-up. Age, discharge modified Rankin score (mRS), and history of arthritis, osteoporosis, falls and previous fracture contributed significantly to the model. Model discrimination was good (c statistic 0.72). Including discharge mRS significantly improved discrimination (relative integrated discrimination index 8.7%). Fracture risk was highest in patients with mRS 3 and 4 but lowest in bedbound patients (mRS 5). From the lowest to the highest FRAC-Stroke quintile the cumulative incidence of 1-year low trauma fracture increased from 1% to 9%. Predicted and observed rates of fracture were similar in the external validation cohort. Conclusion: The FRAC-Stroke score allows the clinician to identify ischemic stroke patients at higher risk of low trauma fracture within one year. This information might be used to target patients for early bone densitometry screening to diagnose and manage osteoporosis, and to estimate baseline risk prior to starting pioglitazone therapy.

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