Key result
VA women CVD score improves 10-year ASCVD risk prediction over pooled cohort equations in White women.
Why the study?
The current ACC/AHA women CVD risk score suboptimally estimates CVD risk for young and minority women in the military.
Does the newly developed VA women CVD risk score improve the accuracy of 10-year ASCVD risk prediction compared to the ACC/AHA pooled cohort score in women veterans?
Cohort (n=69,574)
Yes
Does the newly developed VA women CVD risk score improve the accuracy of 10-year ASCVD risk prediction compared to the ACC/AHA pooled cohort score in women veterans?
The VA women CVD risk score accurately predicts 10-year cardiovascular events in female service members and veterans, identifying additional high-risk patients who would be missed by traditional ACC/AHA pooled cohort models.
Answers are grounded in this paper and cite their sources.
May enhance ASCVD risk stratification in VA women; leaves open prospective validation before practice change.
Background The current American College of Cardiology/American Heart Association women cardiovascular disease (CVD) risk score suboptimally estimates CVD risk for young and minority women in the military. The current study developed an internally validated CVD risk score for women military service members and veterans using the Veterans Affairs (VA) national electronic health records data. Methods and Results The study cohort included 69 574 White, Black, and Hispanic women service members and veterans aged 30 to 79 years in 2007 treated in the VA Health Care System between January 1, 2007 and December 31, 2017 (henceforth, VA women). Stratified by race and ethnicity, the new VA women CVD risk model estimated risk coefficients and 10-year CVD risk using a time-variant covariate Cox model. Harrell C-statistics, calibration plots, and net classification index were used to assess accuracy and prognostic performance of the new VA women CVD risk model. The new internally validated VA women CVD risk score performed better in predicting VA women 10-year atherosclerosis cardiovascular disease risk than the pooled cohort American College of Cardiology/American Heart Association risk score in both accuracy (White Harrell C-statistics, 70% versus 61%; Black, 68% versus 63%) and prognostic performance (White net classification index, 0.31; 95% CI, 0.26-0.33; Black net classification index, 0.06; 95% CI, 0.03-0.09). Conclusions The proposed VA women CVD risk score improves accuracy of the existing American College of Cardiology/American Heart Association CVD risk assessment tool in predicting long-term CVD risk for VA women, particularly in young and racial/ethnic minority women.
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Jeon‐Slaughter et al. (2021) conducted a cohort in Cardiovascular disease risk assessment (n=69,574). VA women CVD risk score vs. ACC/AHA pooled cohort ASCVD risk score was evaluated on Prognostic performance (net classification index) for 10-year ASCVD risk in White women (Net classification index 0.31, 95% CI 0.26-0.33). The internally validated VA women CVD risk score improved 10-year ASCVD risk prediction prognostic performance compared to the ACC/AHA pooled cohort score, yielding a net classification index of 0.31 in White women.
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