Key result
The 30-year Framingham Risk Score adequately discriminates incident CVD events but overestimates actual risk.
Why the study?
Validation of the 30-year Framingham Risk Score was lacking due to complex statistical properties and limited large population-based cohorts with appropriate data.
Does the 30-Year Framingham Risk Score accurately predict long-term cardiovascular disease risk in a German population-based cohort?
Cohort (n=3,110)
Does the 30-Year Framingham Risk Score accurately predict long-term cardiovascular disease risk in a German population-based cohort?
Effect estimate: AUC 78.4 (women), 74.9 (men)
The 30-Year Framingham Risk Score shows adequate discrimination but overestimates actual CVD risk in a German population, suggesting it is useful for long-term risk communication but may require recalibration.
May warrant recalibration for German cohorts before use; leaves open prospective validation of adjusted long-term scores.
The Framingham Risk Score to predict 30-year risk (FRS30y) of cardiovascular disease (CVD) constitutes an important tool for long-term risk prediction. However, due to its complex statistical properties and the paucity of large population-based cohorts with appropriate data, validation of the FRS30y is lacking. A population-based cohort from Southern Germany (N = 3110, 1516 (48.7%) women) was followed up for a median time of 29.5 [18.7, 31.2] years. Discrimination and calibration were assessed for the original, recalibrated and refitted FRS30y version. During follow up, 620 incident CVD events (214 in women) occurred. The FRS30y showed adequate discrimination (original and recalibrated version: Area under the curve (AUC): 78.4 for women and 74.9 for men) but overestimated actual CVD risk (original version: discordance 45.4% for women and 37.3% for men, recalibrated version: 37.6% and 28.6%, respectively). Refitting showed substantial improvement in neither discrimination nor calibration. The performance of FRS30y is adequate for long-term CVD risk prediction and could serve as an important tool in risk communication, especially for younger audiences.
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Rospleszcz et al. (2022) conducted a cohort in Cardiovascular disease (CVD) (n=3,110). 30-Year Framingham Risk Score (FRS30y) was evaluated on Incident CVD events (AUC 78.4 (women), 74.9 (men)). The 30-Year Framingham Risk Score showed adequate discrimination for incident CVD events (AUC 78.4 for women and 74.9 for men) but overestimated actual CVD risk.
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