Why the study?
CVD deaths have increased significantly in China, necessitating risk prediction models to identify people at risk and enable targeted intervention.
Does the CVDMCM model accurately predict 4-year cardiovascular disease risk in Chinese males compared to the Framingham and Wu's simplified models?
Does the CVDMCM model accurately predict 4-year cardiovascular disease risk in Chinese males compared to the Framingham and Wu's simplified models?
A newly developed 5-variable risk prediction model (CVDMCM) accurately predicts 4-year cardiovascular disease risk in Chinese males, demonstrating better discrimination and calibration than established models like Framingham.
May support CVDMCM for risk prediction in Chinese males; leaves open external validation before practice change.
Aims Death due to cardiovascular diseases (CVD) increased significantly in China. One way to reduce CVD is to identify people at risk and provide targeted intervention. We aim to develop and validate a CVD risk prediction model for Chinese males (CVDMCM) to help clinicians identify those at risk of CVD and provide targeted intervention. Methods and Results We conducted a retrospective cohort study of 2331 Chinese males without prior CVD to develop and internally validate the CVDMCM. These participants had a baseline physical examination record (2008-2016) and one revisit record by September 2019. With the full cohort, we used single factor cox regression to examine each candidate predictor adjusted for age. 16 sequential prediction models were built on significant predictors. CVDMCM was selected based on the Akaike information criterion, the area under the ROC curve, and the percentage of variation in outcome values explained by the model (R 2 ). This model, the Framingham CVD risk model, and the Wu’s simplified model were all validated by bootstrapping with 1000 repetitions. CVDMCM’s C statistics (0.779, 95% CI: 0.733-0.825), D statistic (4.738, 95% CI: 3.270-6.864), and calibration plot demonstrated that CVDMCM outperformed the other two models. Conclusions We developed and internally validated CVDMCM, which predicted 4-year CVD risk for Chinese males with a better performance than Framingham CVD model and Wu’s simplified model. In addition, we developed a web calculator for physicians to conveniently generate CVD risk scores and identify those with a higher risk of CVD. We believe CVDMCM had great potential for clinical usage.
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Shan et al. (2022) studied this question.
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