C-reactive protein and parental history improve global cardiovascular risk prediction: the Reynolds Risk Score for...

Area of Science:

• Cardiology
• Preventive Medicine
• Biostatistics

Background:

• Cardiovascular disease (CVD) risk prediction is crucial for preventive strategies.
• High-sensitivity C-reactive protein (hs-CRP) and family history are established CVD risk factors.
• Existing risk models, like the Reynolds Risk Score for women, incorporate these factors, but a comparable model for men was lacking.

Purpose of the Study:

• To develop and validate a cardiovascular risk prediction model for men incorporating hs-CRP and parental history of myocardial infarction.
• To compare the performance of this new model against a traditional risk factor model.

Main Methods:

• Prospective analysis of 10,724 initially healthy American nondiabetic men.
• Development of two prediction models: a traditional model and the Reynolds Risk Score for men (including hs-CRP and parental history).
• Evaluation of global model fit, discrimination (C-index), calibration, and reclassification accuracy.

Main Results:

• The Reynolds Risk Score for men demonstrated superior global fit and discrimination compared to the traditional model.
• It reclassified a significant proportion of men into different risk categories with improved accuracy.
• Net reclassification indices (NRI and clinical NRI) were statistically significant, indicating improved risk stratification.

Conclusions:

• The Reynolds Risk Score for men, incorporating hs-CRP and parental history, significantly enhances global cardiovascular risk prediction in men.
• This model offers improved accuracy for identifying men at higher or lower cardiovascular event risk.