Novel score may predict CV event risk similarly to ASCVD risk score
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A novel score to predict 10-year risk for incident CV events using patient-reported information was comparable to the atherosclerotic CVD risk score, according to a study published in the Journal of the American Heart Association.
“It’s going to have to be accepted that the predictive value is the same as the one endorsed by the American Heart Association because some people say this is sort of a toy,” Arch G. Mainous III, PhD, chair of the department of health services research, management and policy and Florida Blue Endowed Professor of Health Administration at the University of Florida in Gainesville, told Healio. “As the study shows, it’s not really a toy. It basically predicts equally; it’s not any less predictive than the ASCVD [risk score], yet it’s easier to use and doesn’t require biomarkers, which would require sometimes an extra visit someplace else and then come back.”
ARIC study data
Hend Mansoor, PhD, PharmD, a student of the health services research PhD program at University of Florida College of Public Health and Health Professions at the time of the study and now a research scientist at Sidra Medical and Research Center in Doha, Qatar, and colleagues analyzed data from 9,285 patients (mean age, 60 years; 57% women; 80% black) from the Atherosclerosis Risk in Communities (ARIC) study who were enrolled between 1993 and 1995. Patients were aged 45 to 64 years without a history of CVD. Seventy percent of patients were used for model development and 30% were utilized for validation. Each patient in the validation cohort also had an ASCVD risk score computed.
Traditional and nontraditional CV risk factors were assessed including sex, age, smoking status and previous diagnoses rheumatoid arthritis and gout. The outcome of interest was the first occurrence of a CVD event within 10 years including stroke, CHD and mortality.
Of the patients in the study, 7.47% had an incident CV event during a median follow-up of 8.93 years.
Six factors were independently linked to a 10-year risk for incident CVD, including:
- age groups of 60 to 64 years (HR = 1.8; 95% CI, 1.34-2.41), 65 to 69 years (HR = 2.19; 95% CI, 1.63-2.93) and 70 years and older (HR = 2.74; 95% CI, 1.75-4.26);
- current smoking (HR = 2.41; 95% CI, 1.91-3.04);
- male sex (HR = 1.78; 95% CI, 1.47-2.15); and
- histories of hypertension (HR = 1.75; 95% CI, 1.45-2.11), diabetes (HR = 2.55; 95% CI, 2.02-3.22) and a family member with premature MI (HR = 1.43; 95% CI, 1.07-1.91).
“With this ... you can actually do [the risk score] out in the office, sitting in the waiting room, you can actually do it even the night before ... your appointment,” Mainous said in an interview.
The area under the receiving operator curve was 0.714 for the development cohort and 0.721 for the validation cohort with good calibration. The C-statistic for the ASCVD risk score was 0.745 in the validation cohort and 0.721 for the novel risk score.
Future research
“The EZ-CVD risk score could be easily used by physicians, especially primary care, to assess risk of patients and guide therapeutic decisions regarding statin therapy,” Mansoor and colleagues wrote. “Future studies are needed to externally validate this risk score in cohorts with wide racial diversity, and to assess the applicability of this new risk score in routine clinical practice.” – by Darlene Dobkowski
For more information:
Arch G. Mainous III, PhD, can be reached at Department of Health Services Research, Management and Policy, University of Florida, Health Sciences Center, P.O. Box 100195, Gainesville, FL 32610; email: arch.mainous@phhp.ufl.edu.
Disclosures: The authors report no relevant financial disclosures.
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