Cover Image

Validation of the pooled cohort risk score in an Asian population - a retrospective cohort study

BACKGROUND: The Pooled Cohort Risk Equation was introduced by the American College of Cardiology (ACC) and American Heart Association (AHA) 2013 in their Blood Cholesterol Guideline to estimate the 10-year atherosclerotic cardiovascular disease (ASCVD) risk. However, absence of Asian ethnicity in t...

Full description

Saved in:
Bibliographic Details
Main Authors: Chia, Yook Chin, Lim, Hooi Min, Ching, Siew Mooi
Format: Article
Language:English
Published: BioMed Central 2014
Online Access:http://psasir.upm.edu.my/id/eprint/35961/1/Validation%20of%20the%20pooled%20cohort%20risk%20score%20in%20an.pdf
http://psasir.upm.edu.my/id/eprint/35961/
http://bmccardiovascdisord.biomedcentral.com/articles/10.1186/1471-2261-14-163
Tags: Add Tag
No Tags, Be the first to tag this record!
id my.upm.eprints.35961
record_format eprints
spelling my.upm.eprints.359612016-02-12T02:39:13Z http://psasir.upm.edu.my/id/eprint/35961/ Validation of the pooled cohort risk score in an Asian population - a retrospective cohort study Chia, Yook Chin Lim, Hooi Min Ching, Siew Mooi BACKGROUND: The Pooled Cohort Risk Equation was introduced by the American College of Cardiology (ACC) and American Heart Association (AHA) 2013 in their Blood Cholesterol Guideline to estimate the 10-year atherosclerotic cardiovascular disease (ASCVD) risk. However, absence of Asian ethnicity in the contemporary cohorts and limited studies to examine the use of the risk score limit the applicability of the equation in an Asian population. This study examines the validity of the pooled cohort risk score in a primary care setting and compares the cardiovascular risk using both the pooled cohort risk score and the Framingham General Cardiovascular Disease (CVD) risk score. METHODS: This is a 10-year retrospective cohort study of randomly selected patients aged 40-79 years. Baseline demographic data, co-morbidities and cardiovascular (CV) risk parameters were captured from patient records in 1998. Pooled cohort risk score and Framingham General CVD risk score for each patient were computed. All ASCVD events (nonfatal myocardial infarction, coronary heart disease (CHD) death, fatal and nonfatal stroke) occurring from 1998-2007 were recorded. RESULTS: A total of 922 patients were studied. In 1998, mean age was 57.5 ± 8.8 years with 66.7% female. There were 47% diabetic patients and 59.9% patients receiving anti-hypertensive treatment. More than 98% of patients with pooled cohort risk score ≥7.5% had FRS >10%. A total of 45 CVD events occurred, 22 (7.2%) in males and 23 (3.7%) in females. The median pooled cohort risk score for the population was 10.1 (IQR 4.7-20.6) while the actual ASCVD events that occurred was 4.9% (45/922). Our study showed moderate discrimination with AUC of 0.63. There was good calibration with Hosmer-Lemeshow test χ2 = 12.6, P = 0.12. CONCLUSIONS: The pooled cohort risk score appears to overestimate CV risk but this apparent over-prediction could be a result of treatment. In the absence of a validated score in an untreated population, the pooled cohort risk score appears to be appropriate for use in a primary care setting. BioMed Central 2014 Article PeerReviewed application/pdf en http://psasir.upm.edu.my/id/eprint/35961/1/Validation%20of%20the%20pooled%20cohort%20risk%20score%20in%20an.pdf Chia, Yook Chin and Lim, Hooi Min and Ching, Siew Mooi (2014) Validation of the pooled cohort risk score in an Asian population - a retrospective cohort study. BMC Cardiovascular Disorders, 14. art. no. 163. pp. 1-7. ISSN 1471-2261 http://bmccardiovascdisord.biomedcentral.com/articles/10.1186/1471-2261-14-163 10.1186/1471-2261-14-163
institution Universiti Putra Malaysia
building UPM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Putra Malaysia
content_source UPM Institutional Repository
url_provider http://psasir.upm.edu.my/
language English
description BACKGROUND: The Pooled Cohort Risk Equation was introduced by the American College of Cardiology (ACC) and American Heart Association (AHA) 2013 in their Blood Cholesterol Guideline to estimate the 10-year atherosclerotic cardiovascular disease (ASCVD) risk. However, absence of Asian ethnicity in the contemporary cohorts and limited studies to examine the use of the risk score limit the applicability of the equation in an Asian population. This study examines the validity of the pooled cohort risk score in a primary care setting and compares the cardiovascular risk using both the pooled cohort risk score and the Framingham General Cardiovascular Disease (CVD) risk score. METHODS: This is a 10-year retrospective cohort study of randomly selected patients aged 40-79 years. Baseline demographic data, co-morbidities and cardiovascular (CV) risk parameters were captured from patient records in 1998. Pooled cohort risk score and Framingham General CVD risk score for each patient were computed. All ASCVD events (nonfatal myocardial infarction, coronary heart disease (CHD) death, fatal and nonfatal stroke) occurring from 1998-2007 were recorded. RESULTS: A total of 922 patients were studied. In 1998, mean age was 57.5 ± 8.8 years with 66.7% female. There were 47% diabetic patients and 59.9% patients receiving anti-hypertensive treatment. More than 98% of patients with pooled cohort risk score ≥7.5% had FRS >10%. A total of 45 CVD events occurred, 22 (7.2%) in males and 23 (3.7%) in females. The median pooled cohort risk score for the population was 10.1 (IQR 4.7-20.6) while the actual ASCVD events that occurred was 4.9% (45/922). Our study showed moderate discrimination with AUC of 0.63. There was good calibration with Hosmer-Lemeshow test χ2 = 12.6, P = 0.12. CONCLUSIONS: The pooled cohort risk score appears to overestimate CV risk but this apparent over-prediction could be a result of treatment. In the absence of a validated score in an untreated population, the pooled cohort risk score appears to be appropriate for use in a primary care setting.
format Article
author Chia, Yook Chin
Lim, Hooi Min
Ching, Siew Mooi
spellingShingle Chia, Yook Chin
Lim, Hooi Min
Ching, Siew Mooi
Validation of the pooled cohort risk score in an Asian population - a retrospective cohort study
author_facet Chia, Yook Chin
Lim, Hooi Min
Ching, Siew Mooi
author_sort Chia, Yook Chin
title Validation of the pooled cohort risk score in an Asian population - a retrospective cohort study
title_short Validation of the pooled cohort risk score in an Asian population - a retrospective cohort study
title_full Validation of the pooled cohort risk score in an Asian population - a retrospective cohort study
title_fullStr Validation of the pooled cohort risk score in an Asian population - a retrospective cohort study
title_full_unstemmed Validation of the pooled cohort risk score in an Asian population - a retrospective cohort study
title_sort validation of the pooled cohort risk score in an asian population - a retrospective cohort study
publisher BioMed Central
publishDate 2014
url http://psasir.upm.edu.my/id/eprint/35961/1/Validation%20of%20the%20pooled%20cohort%20risk%20score%20in%20an.pdf
http://psasir.upm.edu.my/id/eprint/35961/
http://bmccardiovascdisord.biomedcentral.com/articles/10.1186/1471-2261-14-163
_version_ 1643831608149540864
score 13.211869

Similar Items