Comparing Cardiovascular Risk Prediction Scores

Editorials17 February 2015Comparing Cardiovascular Risk Prediction ScoresPaul M Ridker, MD, MPH and Nancy R. Cook, ScDPaul M Ridker, MD, MPHFrom Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts. and Nancy R. Cook, ScDFrom Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M14-2820 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In this issue, DeFilippis and colleagues (1) present a long-awaited evaluation of discrimination and calibration achieved by 4 cardiovascular risk prediction algorithms published between 1998 and 2008 and compare these with the new American Heart Association (AHA) and American College of Cardiology (ACC) "pooled cohort" risk calculator released in 2014. They perform their analysis in MESA (Multi-Ethnic Study of Atherosclerosis; sponsored by the National Heart, Lung, and Blood Institute), which is a contemporary cohort designed to represent the multiethnic U.S. population. Of note, MESA was not used to develop any of the 5 risk scores being compared. DeFilippis and colleagues ...References1. DeFilippis AP, Young R, Carrubba CJ, McEvoy JW, Budoff MJ, Blumenthal RS, et al. An analysis of calibration and discrimination among multiple cardiovascular risk scores in a modern multiethnic cohort. Ann Intern Med. 2015;162:266-75. doi:10.7326/M14-2820 Google Scholar2. Stone NJ, Robinson JG, Lichtenstein AH, Bairey Merz CN, Blum CB, Eckel RH, et al; American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129:S1-45. [PMID: 24222016] doi:10.1161/01.cir.0000437738.63853.7a CrossrefMedlineGoogle Scholar3. Cook NR, Paynter NP, Eaton CB, Manson JE, Martin LW, Robinson JG, et al. Comparison of the Framingham and Reynolds Risk scores for global cardiovascular risk prediction in the multiethnic Women's Health Initiative. Circulation. 2012;125:1748-56, S1-11. [PMID: 22399535] doi:10.1161/CIRCULATIONAHA.111.075929 CrossrefMedlineGoogle Scholar4. Goff DC, Lloyd-Jones DM, Bennett G, Coady S, D'Agostino RB, Gibbons R, et al; American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63:2935-59. [PMID: 24239921] doi:10.1016/j.jacc.2013.11.005 CrossrefMedlineGoogle Scholar5. Ridker PM, Cook NR. Statins: new American guidelines for prevention of cardiovascular disease. Lancet. 2013;382:1762-5. [PMID: 24268611] doi:10.1016/S0140-6736(13)62388-0 CrossrefMedlineGoogle Scholar6. Kavousi M, Leening MJ, Nanchen D, Greenland P, Graham IM, Steyerberg EW, et al. Comparison of application of the ACC/AHA guidelines, Adult Treatment Panel III guidelines, and European Society of Cardiology guidelines for cardiovascular disease prevention in a European cohort. JAMA. 2014;311:1416-23. [PMID: 24681960] doi:10.1001/jama.2014.2632 CrossrefMedlineGoogle Scholar7. Muntner P, Colantonio LD, Cushman M, Goff DC, Howard G, Howard VJ, et al. Validation of the atherosclerotic cardiovascular disease Pooled Cohort risk equations. JAMA. 2014;311:1406-15. [PMID: 24682252] doi:10.1001/jama.2014.2630 CrossrefMedlineGoogle Scholar8. Cook NR, Ridker PM. Further insight into the cardiovascular risk calculator: the roles of statins, revascularizations, and underascertainment in the Women's Health Study. JAMA Intern Med. 2014;174:1964-71. [PMID: 25285455] doi:10.1001/jamainternmed.2014.5336 CrossrefMedlineGoogle Scholar9. Sattar N, Preiss D, Murray HM, Welsh P, Buckley BM, deCraen AJ, et al. Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials. Lancet. 2010;375:735-42. [PMID: 20167359] doi:10.1016/S0140-6736(09)61965-6 CrossrefMedlineGoogle Scholar10. Ridker PM, Wilson PW. A trial-based approach to statin guidelines. JAMA. 2013;310:1123-4. [PMID: 23942579] doi:10.1001/jama.2013.276529 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-2820.Corresponding Author: Paul M Ridker, MD, MPH, Center for Cardiovascular Disease Prevention, Brigham & Women's Hospital, 900 Commonwealth Avenue, Boston, MA 02215; e-mail, [email protected]org.Current Author Addresses: Drs. Ridker and Cook: Center for Cardiovascular Disease Prevention, Divisions of Preventive Medicine and Cardiology, Brigham & Women's Hospital, 900 Commonwealth Avenue, Boston, MA 02215. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAn Analysis of Calibration and Discrimination Among Multiple Cardiovascular Risk Scores in a Modern Multiethnic Cohort Andrew P. DeFilippis , Rebekah Young , Christopher J. Carrubba , John W. McEvoy , Matthew J. Budoff , Roger S. Blumenthal , Richard A. Kronmal , Robyn L. McClelland , Khurram Nasir , and Michael J. Blaha An Analysis of Calibration and Discrimination Among Multiple Cardiovascular Risk Scores in a Modern Multiethnic Cohort Andrew P. DeFilippis , Rebekah Young , Christopher J. Carrubba , John W. McEvoy , Matthew J. Budoff , Roger S. Blumenthal , Richard A. Kronmal , Robyn L. McClelland , Khurram Nasir , and Michael J. Blaha Metrics Cited ByPrognostic value of electrocardiographic abnormalities in adults from the Brazilian longitudinal study of adults' healthCoronary Artery Calcium: Where Do We Stand After Over 3 Decades?Cardiovascular disease (CVD) risk scores, age, or years since menopause to predict cardiovascular disease in the Women's Health InitiativeThree Dimensional Carotid and Femoral Ultrasound is not Superior to Two Dimensional Ultrasound as a Predictor of Coronary Atherosclerosis Among Men With Intermediate Cardiovascular RiskDiscrimination between Obstructive Coronary Artery Disease and Cardiac Syndrome X in Women with Typical Angina and Positive Exercise Test; Utility of Cardiovascular Risk CalculatorsPrevalence of sleep apnea and cardiovascular risk factors in patients with hypertension in a day hospital modelThe Veterans Affairs Cardiac Risk ScoreStatins for primary prevention in physically active individuals: Do the risks outweigh the benefits?Use of cardiovascular age for assessing risks and benefits of menopausal hormone therapyUse and Customization of Risk Scores for Predicting Cardiovascular Events Using Electronic Health Record DataDetermining optimal threshold for statins prescribing: individualization of statins treatment for primary prevention of cardiovascular diseaseTowards theory integration: Threshold model as a link between signal detection theory, fast-and-frugal trees and evidence accumulation theoryStatins in Primary Prevention: Uncertainties and Gaps in Randomized Trial DataLong-Term Outcomes of Short-Term Statin Use in Healthy Adults: A Retrospective Cohort StudyPrimary Prevention With StatinsNational Lipid Association Recommendations for Patient-Centered Management of Dyslipidemia: Part 2The pseudo-high-risk prevention strategyCurrent Treatment of Dyslipidemia: A New Paradigm for Statin Drug Use and the Need for Additional TherapiesCelebrating the ACP Centennial: From the Annals ArchiveDeborah Cotton, MD, MPH, Deputy Editor 17 February 2015Volume 162, Issue 4Page: 313-314KeywordsAlgorithmsAtherosclerosisCardiovascular disease riskCardiovascular diseasesCohort studiesLongitudinal studiesObstetrics and gynecologyRisk managementStatins ePublished: 17 February 2015 Issue Published: 17 February 2015 CopyrightCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...