Comparative Analysis of Three Atherosclerotic Cardiovascular Disease Risk Prediction Models in Individuals Aged 75 and Older

IF 3.6 3区医学

Clinical Interventions in Aging Pub Date : 2024-03-20 DOI:10.2147/cia.s454060

Zhang Wang, Xue Yang, Longxin Li, Xiaobo Zhang, Wenlin Zhou, Sixue Chen

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Abstract

Purpose: To evaluate the performance of the Framingham cardiovascular risk score (FRS)/pooled cohort equations (PCE)/China prediction for atherosclerotic cardiovascular disease (ASCVD) risk (China-PAR model) in a prospective cohort of Chinese older adults.
Patients and Methods: We assessed 717 older adults aged 75– 85 years without ASCVD at the baseline from the Sichuan province of China. The participants were followed annually from 2011 to 2021. We obtained the participants’ information through the medical records of physical examination and evaluated their 10-year ASCVD risk using FRS, PCE, and China-PAR. We further evaluated the predictive abilities of three assessment models.
Results: During the 10-year follow-up, 206 participants developed ASCVD, with an incidence rate of 28.73%. The FRS and China-PAR moderately underestimated the risk of ASCVD (22.1% and 12.4%, respectively), but while PCE overestimated the risk (36.1%). FRS and China-PAR were found to underestimate the risk of ASCVD (26% and 63%, respectively) for men, while PCE overestimated the risk by 8%; For women, FRS and China-PAR were found to underestimate the risk of ASCVD (14% and 35%, respectively), while PCE overestimated the risk by 88%.
Conclusion: The 10-year ASCVD risk was found to be overestimated by PCE. China-PAR had the most accurate predictions in women, while FRS was particularly well-calibrated in males. All three risk models have good discrimination, with FRS and PCE being well-calibrated in men and all three being well-calibrated in women. Therefore, accurate risk models are warranted to facilitate the prevention of ASCVD at the baseline among Chinese older adults.

Keywords: ASCVD, risk prediction model, FRS, PCE, China-PAR

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三种 75 岁及以上人群动脉粥样硬化性心血管疾病风险预测模型的比较分析

目的：在中国老年人前瞻性队列中评估弗雷明汉心血管风险评分（FRS）/集合队列方程（PCE）/中国动脉粥样硬化性心血管疾病（ASCVD）风险预测（China-PAR 模型）的性能：我们对中国四川省 717 名 75-85 岁、基线年龄无 ASCVD 的老年人进行了评估。从 2011 年到 2021 年，我们每年对这些参与者进行随访。我们通过体检记录获得了参与者的信息，并使用 FRS、PCE 和 China-PAR 评估了他们的 10 年 ASCVD 风险。我们进一步评估了三种评估模型的预测能力：结果：在 10 年的随访中，206 名参与者发生了 ASCVD，发生率为 28.73%。FRS和China-PAR中度低估了ASCVD的风险（分别为22.1%和12.4%），而PCE则高估了风险（36.1%）。对于男性，FRS和中国-PAR低估了ASCVD风险（分别为26%和63%），而PCE高估了8%；对于女性，FRS和中国-PAR低估了ASCVD风险（分别为14%和35%），而PCE高估了88%：结论：发现 PCE 高估了 10 年 ASCVD 风险。结论：发现 PCE 高估了 10 年 ASCVD 风险。China-PAR 对女性的预测最为准确，而 FRS 对男性的预测尤其准确。所有三种风险模型都有很好的区分度，FRS 和 PCE 对男性的校准效果很好，而所有三种模型对女性的校准效果都很好。因此，需要建立准确的风险模型，以促进中国老年人在基线上预防ASCVD：ASCVD、风险预测模型、FRS、PCE、中国-PAR

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来源期刊

Clinical Interventions in Aging GERIATRICS & GERONTOLOGY-

CiteScore

6.20

自引率

2.80%

发文量

193

期刊介绍： Clinical Interventions in Aging, is an online, peer reviewed, open access journal focusing on concise rapid reporting of original research and reviews in aging. Special attention will be given to papers reporting on actual or potential clinical applications leading to improved prevention or treatment of disease or a greater understanding of pathological processes that result from maladaptive changes in the body associated with aging. This journal is directed at a wide array of scientists, engineers, pharmacists, pharmacologists and clinical specialists wishing to maintain an up to date knowledge of this exciting and emerging field.