Related Experiment Videos
A risk score predicted coronary heart disease and stroke in a Chinese cohort
Xiao-Fei Zhang1, John Attia, Catherine D'Este
1Department of Epidemiology, Cardiovascular Institute and Fu Wai Hospital, Peking Union Medical College, People's Republic of China. zhang_xiaofei@hotmail.com
Insights
Existing coronary heart disease (CHD) risk scores overestimate risk in Chinese men. A new cardiovascular disease (CVD) risk score was developed and validated for this population, improving prediction accuracy.
Area of Science:
- Cardiovascular epidemiology
- Risk prediction modeling
- Public health
Background:
- Existing cardiovascular disease (CVD) risk scores, often derived from Caucasian populations, may not accurately predict risk in diverse ethnic groups.
- Accurate risk stratification is crucial for effective primary prevention of coronary heart disease (CHD) and stroke.
Purpose of the Study:
- To evaluate the applicability of Caucasian-derived risk scores for coronary heart disease (CHD) in a Chinese male population.
- To develop and validate a novel cardiovascular disease (CVD) risk prediction score specifically for Chinese men.
Main Methods:
- A cohort of 4,400 Chinese men was followed for an average of 13.5 years.
- Cox proportional hazards models were used to predict 10-year risk of CHD, ischemic stroke, and hemorrhagic stroke.
- Risk prediction models were developed and validated using standard statistical techniques, including assessment of predictive ability via area under the receiver operating characteristic curves (AUC).
Main Results:
- Caucasian-derived risk scores significantly overestimated CHD risk in the Chinese cohort.
- The newly derived risk models demonstrated good predictive performance.
- AUC values in the validation set were 0.76 for CHD, 0.78 for ischemic stroke, and 0.82 for hemorrhagic stroke.
Conclusions:
- Risk stratification rules developed in Caucasian populations are inadequate for predicting CHD in Chinese men.
- A specific risk stratification rule for CHD, ischemic stroke, and hemorrhagic stroke has been developed and validated for Chinese men.
- This study provides a more accurate tool for cardiovascular risk assessment in the Chinese male population.
Background And Objective:
This article aims to address two issues: first, whether risk scores derived from Caucasian cohorts can accurately predict coronary heart disease (CHD) in a Chinese population; second, derivation and validation of a new risk prediction score for cardiovascular disease (CVD) from a Chinese cohort.
Methods:
A cohort of 4,400 male steelworkers (18-74 years old) recruited between 1974-1980 was followed up for an average 13.5 years. A Cox model was used to predict 10 year risk of CHD, ischemic, and hemorrhagic stroke based on blood pressure, age, total cholesterol, body mass index, and smoking status.
Results:
The prediction rule from the European Recommendations greatly overestimates the risk of CHD in Orientals. The new models had good predictive ability, with the area under receiver operating characteristic curves (AUCs area) in the derivation set being 0.76, 0.72, and 0.82 for CHD, ischemic, and hemorrhagic stroke separately; AUCs in the validation set were equally good, at 0.76, 0.78, and 0.82, respectively.
Conclusion:
The risk stratification rules derived from Caucasian cohorts overestimates the CHD risk in Orientals, and we derive a specific risk stratification rule for CHD, ischemic and hemorrhagic stroke for Chinese men.
Related Concept Videos
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:26Coronary Artery Disease IV: Preventive Measures
01:30Coronary Artery Disease I: Introduction