Why the study?
The Framingham Risk Score predicts coronary heart disease, but its assessment has been unsuccessful in Asian populations.
Do new risk prediction models combining waist circumference or proteinuria with the Suita score improve the prediction of 3-year risk of coronary heart disease compared to standard scores in a Japanese population?
Do new risk prediction models combining waist circumference or proteinuria with the Suita score improve the prediction of 3-year risk of coronary heart disease compared to standard scores in a Japanese population?
Adding waist circumference in men or proteinuria in women to the Suita score improves 3-year coronary heart disease risk prediction in Japanese diabetic patients.
No immediate practice change warranted; leaves open whether adding waist circumference or proteinuria extends Suita score utility in Japanese diabetics.
The Framingham Risk Score (FRS) has been reported to predict coronary heart disease (CHD), but its assessment has been unsuccessful in Asian population. We aimed to assess FRS and Suita score (a Japanese CHD prediction model) in a Japanese nation-wide annual health check program, participants aged 40-79 years were followed up longitudinally from 2008 to 2011. Of 35,379 participants analyzed, 1,234 had new-onset CHD. New-onset CHD was observed in diabetic men [6.00%], non-diabetic men [3.96%], diabetic women [5.51%], and non-diabetic women [2.86%], respectively. Area under the curve (AUC) of receiver operating characteristic (ROC) curve for CHD prediction were consistently low in Suita score (TC), FRS (TC) and NCEP-ATPIII FRS (TC), suggesting that these scores have only a limited power. ROC, net reclassification improvement (NRI), integrated discrimination improvement (IDI), and decision curve analysis (DCA) and Hosmer-Lemeshow goodness-of-fit test did not show clear differences between Suita score (TC) and FRS (TC). New models combining waist circumference ≥85 cm in men or proteinuria ≥1+ in women to Suita score (TC) was superior in diabetic men and women. New models could be useful to predict 3-year risk of CHD at least in Japanese population especially in diabetic population.
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Hirai et al. (2019) studied this question.
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