Calibration and Discrimination Among Multiple Cardiovascular Risk Scores in a Modern Multiethnic Cohort

Letters7 July 2015Calibration and Discrimination Among Multiple Cardiovascular Risk Scores in a Modern Multiethnic CohortDavid C. Goff Jr., MD, PhD, Ralph B. D'Agostino Sr., PhD, Michael Pencina, PhD, and Donald M. Lloyd-Jones, MD, ScMDavid C. Goff Jr., MD, PhDFrom Colorado School of Public Health, Denver, Colorado; Boston University, Boston, Massachusetts; Duke University, Durham, North Carolina; and Northwestern University, Chicago, Illinois., Ralph B. D'Agostino Sr., PhDFrom Colorado School of Public Health, Denver, Colorado; Boston University, Boston, Massachusetts; Duke University, Durham, North Carolina; and Northwestern University, Chicago, Illinois., Michael Pencina, PhDFrom Colorado School of Public Health, Denver, Colorado; Boston University, Boston, Massachusetts; Duke University, Durham, North Carolina; and Northwestern University, Chicago, Illinois., and Donald M. Lloyd-Jones, MD, ScMFrom Colorado School of Public Health, Denver, Colorado; Boston University, Boston, Massachusetts; Duke University, Durham, North Carolina; and Northwestern University, Chicago, Illinois.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-5105 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:DeFilippis and colleagues (1) evaluated the predictive utility of the 2013 American College of Cardiology (ACC) and American Heart Association (AHA) pooled cohort equations in the MESA (Multi-Ethnic Study of Atherosclerosis) cohort and reported what they perceive to be overprediction. The guideline identified and thoroughly discussed this potential problem (2, 3). DeFilippis and colleagues attempted to explore it in more detail, but their analyses have substantial methodological problems.Coronary artery calcium (CAC) was scored in MESA participants at least twice during the study. Knowledge of the results was associated with greater initiation of preventive therapies, especially among ...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. [PMID: 25686167] doi:10.7326/M14-1281 LinkGoogle Scholar2. 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 Scholar3. 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. Circulation. 2014;129:S49-73. [PMID: 24222018] doi:10.1161/01.cir.0000437741.48606.98 CrossrefMedlineGoogle Scholar4. Nasir K, McClelland RL, Blumenthal RS, Goff DC, Hoffmann U, Psaty BM, et al. Coronary artery calcium in relation to initiation and continuation of cardiovascular preventive medications: the Multi-Ethnic Study of Atherosclerosis (MESA). Circ Cardiovasc Qual Outcomes. 2010;3:228-35. [PMID: 20371760] doi:10.1161/CIRCOUTCOMES.109.893396 CrossrefMedlineGoogle Scholar5. Pencina MJ, Navar-Boggan AM, D'Agostino RB, Williams K, Neely B, Sniderman AD, et al. Application of new cholesterol guidelines to a population-based sample. N Engl J Med. 2014;370:1422-31. [PMID: 24645848] doi:10.1056/NEJMoa1315665 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: David C. GoffJr., MD, PhD; Ralph B. D'AgostinoSr., PhD; Michael Pencina, PhD; Donald M. Lloyd-Jones, MD, ScMAffiliations: From Colorado School of Public Health, Denver, Colorado; Boston University, Boston, Massachusetts; Duke University, Durham, North Carolina; and Northwestern University, Chicago, Illinois.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L15-0199. 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 Calibration and Discrimination Among Multiple Cardiovascular Risk Scores in a Modern Multiethnic Cohort Andrew P. DeFilippis , Rebekah Young , and Michael J. Blaha Calibration and Discrimination Among Multiple Cardiovascular Risk Scores in a Modern Multiethnic Cohort Andrew P. DeFilippis , Rebekah Young , and Michael J. Blaha Metrics Cited byPerformance of the Framingham risk models and pooled cohort equations for predicting 10-year risk of cardiovascular disease: a systematic review and meta-analysisResponse by Vallejo-Vaz et al to Letters Regarding Article, "Low-Density Lipoprotein Cholesterol Lowering for the Primary Prevention of Cardiovascular Disease Among Men With Primary Elevations of Low-Density Lipoprotein Cholesterol Levels of 190 mg/dL or Above: Analyses From the WOSCOPS (West of Scotland Coronary Prevention Study) 5-Year Randomized Trial and 20-Year Observational Follow-Up"A Simple Disease-Guided Approach to Personalize ACC/AHA-Recommended Statin Allocation in Elderly People 7 July 2015Volume 163, Issue 1Page: 68KeywordsAtherosclerotic cardiovascular diseaseCoronary artery calcificationDisclosureDrugsForecastingHeartHispanic peopleLongitudinal studiesPreventive medicineRacial and ethnic issues ePublished: 7 July 2015 Issue Published: 7 July 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. 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