Please use this identifier to cite or link to this item:
Title: Prognostic validation of a non-laboratory and a laboratory based cardiovascular disease risk score in multiple regions of the world
Authors: Joseph, Philip
Yusuf, Salim
Lee, Shun Fu
Ibrahim, Quazi
Teo, Koon
Rangarajan, Sumathy
Gupta, Rajeev
Rosengren, Annika
Lear, Scott A.
Avezum, Alvaro
López Jaramillo, Patricio
Gulec, Sadi
Yusufali, Afzalhussein
Chifamba, Jephat
Lanas, Fernando
Kumar, Rajesh
Mohammadifard, Noushin
Mohan, Viswanathan
Mony, Prem
Kruger, Annamarie
Liu, Xu
Guo, Baoxia
Zhao, Wenqi
Yang, Youzhu
Pillai, Rajamohanan
Diaz, Rafael
Krishnapillai, Ambigga
Iqbal, Romaina
Yusuf, Rita
Szuba, Andrzej
Anand, Sonia S.
Keywords: cardiovascular disease
Risk Score
Issue Date: 2018
Abstract: Objective To evaluate the performance of the non-laboratory INTERHEART risk score (NL-IHRS) to predict incident cardiovascular disease (CVD) across seven major geographic regions of the world. The secondary objective was to evaluate the performance of the fasting cholesterol-based IHRS (FC-IHRS). Methods Using measures of discrimination and calibration, we tested the performance of the NL-IHRS (n=100 475) and FC-IHRS (n=107 863) for predicting incident CVD in a community-based, prospective study across seven geographic regions: South Asia, China, Southeast Asia, Middle East, Europe/North America, South America and Africa. CVD was defined as the composite of cardiovascular death, myocardial infarction, stroke, heart failure or coronary revascularisation. Results Mean age of the study population was 50.53 (SD 9.79) years and mean follow-up was 4.89 (SD 2.24) years. The NL-IHRS had moderate to good discrimination for incident CVD across geographic regions (concordance statistic (C-statistic) ranging from 0.64 to 0.74), although recalibration was necessary in all regions, which improved its performance in the overall cohort (increase in C-statistic from 0.69 to 0.72, p<0.001). Regional recalibration was also necessary for the FC-IHRS, which also improved its overall discrimination (increase in C-statistic from 0.71 to 0.74, p<0.001). In 85 078 participants with complete data for both scores, discrimination was only modestly better with the FC-IHRS compared with the NL-IHRS (0.74 vs 0.73, p<0.001). Conclusions External validations of the NL-IHRS and FC-IHRS suggest that regionally recalibrated versions of both can be useful for estimating CVD risk across a diverse range of community-based populations. CVD prediction using a non-laboratory score can provide similar accuracy to laboratory-based methods.
Description: 7 p.
ISSN: 1355-6037
Appears in Collections:DCABA. Artículos de Investigación

This item is licensed under a Creative Commons License Creative Commons