New 10-Year Atherosclerosis Cardiovascular Disease Risk Score for Asian and American Indian Women Service Members

To date, there is no validated atherosclerosis cardiovascular disease risk calculator developed for Asian/Hawaiian (Asian) Americans and American Indian/Alaska Native (AI) women service members based on large, representative data.

This study developed a validated Department of Veterans Affairs (VA) women cardiovascular disease (CVD) risk score for Asian and AI women service members and veterans aged 20 to 80 using VA and Military Health System electronic health record data, largest electronic health record data in the United States.

The study extracted data from the VA Corporate Data Warehouse and selected 15,042 unique Asian and 5,663 AI women service members and veterans who received care from the VA and Military Health System between 2007 and 2022. Closely following the model construct of the VA women CVD risk score, a time-varying covariate Cox model was used to estimate effects of CVD predictors-age, untreated and treated systolic blood pressure, antihypertensive medication, total cholesterol, high-density lipoprotein cholesterol, diabetes, active smoking, and major depression-for each race group separately. Internal and cross validation of the models was conducted.

The VA women CVD risk score for Asian and AI women service members showed good model accuracy, with C-statistics of 0.78 and 0.77, respectively. The calibration plots showed approximation to a 45° line-perfect model fit, and internal validation and cross-validation results showed good validation.

The new Asian/AI VA women CVD risk scores showed both good discrimination and accuracy and, thus, are appropriate to assess 10-year atherosclerosis CVD risk for Asian and AI women service members and veterans.