Risk prediction of cardiovascular disease in the Asia-Pacific region: the SCORE2 Asia-Pacific model.

10-year CVD risk Risk prediction cardiovascular disease primary prevention

Journal

European heart journal

ISSN: 1522-9645

Titre abrégé: Eur Heart J

Pays: England

ID NLM: 8006263

Informations de publication

Date de publication:
01 Sep 2024

Historique:

received: 28 06 2024

revised: 08 08 2024

accepted: 22 08 2024

medline: 1 9 2024

pubmed: 1 9 2024

entrez: 1 9 2024

Statut: aheadofprint

Résumé

To improve upon the estimation of 10-year cardiovascular disease (CVD) event risk for individuals without prior CVD or diabetes mellitus in the Asia-Pacific region by systematic recalibration of the SCORE2 risk algorithm. The sex-specific and competing risk-adjusted SCORE2 algorithms were systematically recalibrated to reflect CVD incidence observed in four Asia-Pacific risk regions, defined according to country-level World Health Organization age- and sex-standardized CVD mortality rates. Using the same approach as applied for the original SCORE2 models, recalibration to each risk region was completed using expected CVD incidence and risk factor distributions from each region. Risk region-specific CVD incidence was estimated using CVD mortality and incidence data on 8,405,574 individuals (556,421 CVD events). For external validation, data from 9,560,266 individuals without previous CVD or diabetes were analysed in 13 prospective studies from 12 countries (350,550 incident CVD events). The pooled C-index of the SCORE2 Asia-Pacific algorithms in the external validation data sets was 0.710 (95% confidence interval [CI] 0.677-0.745). Cohort-specific C-indices ranged from 0.605 (95% CI 0.597-0.613) to 0.840 (95% CI 0.771-0.909). Estimated CVD risk varied several-fold across Asia-Pacific risk regions. For example, the estimated 10-year CVD risk for a 50-year-old non-smoker, with a systolic blood pressure of 140 mmHg, total cholesterol of 5.5 mmol/L, and high-density lipoprotein-cholesterol of 1.3 mmol/L, ranged from 7% for men in low-risk countries to 14% for men in very-high-risk countries, and from 3% for women in low-risk countries to 13% for women in very-high-risk countries. The SCORE2 Asia-Pacific algorithms have been calibrated to estimate 10-year risk of CVD for apparently healthy people in Asia and Oceania, thereby enhancing the identification of individuals at higher risk of developing CVD across the Asia-Pacific region.

Sections du résumé

BACKGROUND AND AIMS OBJECTIVE

METHODS METHODS

The sex-specific and competing risk-adjusted SCORE2 algorithms were systematically recalibrated to reflect CVD incidence observed in four Asia-Pacific risk regions, defined according to country-level World Health Organization age- and sex-standardized CVD mortality rates. Using the same approach as applied for the original SCORE2 models, recalibration to each risk region was completed using expected CVD incidence and risk factor distributions from each region.

RESULTS RESULTS

Risk region-specific CVD incidence was estimated using CVD mortality and incidence data on 8,405,574 individuals (556,421 CVD events). For external validation, data from 9,560,266 individuals without previous CVD or diabetes were analysed in 13 prospective studies from 12 countries (350,550 incident CVD events). The pooled C-index of the SCORE2 Asia-Pacific algorithms in the external validation data sets was 0.710 (95% confidence interval [CI] 0.677-0.745). Cohort-specific C-indices ranged from 0.605 (95% CI 0.597-0.613) to 0.840 (95% CI 0.771-0.909). Estimated CVD risk varied several-fold across Asia-Pacific risk regions. For example, the estimated 10-year CVD risk for a 50-year-old non-smoker, with a systolic blood pressure of 140 mmHg, total cholesterol of 5.5 mmol/L, and high-density lipoprotein-cholesterol of 1.3 mmol/L, ranged from 7% for men in low-risk countries to 14% for men in very-high-risk countries, and from 3% for women in low-risk countries to 13% for women in very-high-risk countries.

CONCLUSIONS CONCLUSIONS

The SCORE2 Asia-Pacific algorithms have been calibrated to estimate 10-year risk of CVD for apparently healthy people in Asia and Oceania, thereby enhancing the identification of individuals at higher risk of developing CVD across the Asia-Pacific region.

Identifiants

DOI: 10.1093/eurheartj/ehae609 PMID: 39217477

pubmed: 39217477

pii: 7741118

doi: 10.1093/eurheartj/ehae609

pii:

doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Investigateurs

Steven Hj Hageman (SH)

Zijuan Huang (Z)

Hokyou Lee (H)

Stephen Kaptoge (S)

Jannick An Dorresteijn (JA)

Lisa Pennells (L)

Emanuele Di Angelantonio (E)

Frank Lj Visseren (FL)

Hyeon Chang Kim (HC)

Sofian Johar (S)

Noraidatulakma Abdullah (N)

Muhammad Irfan Abdul Jalal (MI)

Elizabeth Lm Barr (EL)

Parinya Chamnan (P)

Chean Lin Chong (CL)

Lucky Cuenza (L)

Pei Gao (P)

Ian Graham (I)

Saima Hilal (S)

Joris Holtrop (J)

Rahman Jamal (R)

Tosha Ashish Kalhan (TA)

Hidehiro Kaneko (H)

Chi-Ho Lee (CH)

Charlie Gy Lim (CG)

Xiaofei Liu (X)

Dianna J Magliano (DJ)

Nima Motamed (N)

Maziar Moradi-Lakeh (M)

Sok King Ong (SK)

Ruwanthi Perera (R)

Kameshwar Prasad (K)

Jonathan E Shaw (JE)

Janaka de Silva (J)

Xueling Sim (X)

Yuta Suzuki (Y)

Kathryn Cb Tan (KC)

Xun Tang (X)

Kavita Venkataraman (K)

Rajitha Wickremasinghe (R)

Hideo Yasunaga (H)

Farhad Zamani (F)

Emanuele Di Angelantonio (E)

Michael Papadakis (M)

Adam Timmis (A)

Victor Aboyans (V)

Panos Vardas (P)

Frank Lj Visseren (FL)

John William McEvoy (JW)

Maryam Kavousi (M)

Jean Ferrieres (J)

Radu Huculeci (R)

Alex Junia (A)

Rungroj Krittayaphong (R)

Quang Ngoc Nguyen (QN)

Abdul Halim Raynaldo (AH)

Alan Fong (A)

Hyo-Soo Kim (HS)

Jack Tan (J)

Issei Komuro (I)

Wael Almahmeed (W)

Khung Keong Yeo (KK)

Junya Ako (J)

Kyung Woo Park (KW)