Key result
The Pooled Cohort Equations overestimated 10-year ASCVD risk for men by 6-13% and underestimated it for women by 25-49%, though all evaluated models demonstrated good discrimination with C-statistics ranging from 0.726 to 0.735.
Why the study?
The performance of the 2013 ACC/AHA Pooled Cohort Equations in a large prospective Korean community-based cohort compared with the FRS-CVD and KRPM was unknown.
Does the 2013 ACC/AHA Pooled Cohort Equations accurately predict ASCVD risk compared to FRS-CVD and KRPM in a Korean community-based cohort?
Cohort (n=7,932)
Does the 2013 ACC/AHA Pooled Cohort Equations accurately predict ASCVD risk compared to FRS-CVD and KRPM in a Korean community-based cohort?
In a Korean cohort, the ACC/AHA Pooled Cohort Equations showed good discrimination but required recalibration for accurate ASCVD risk estimation, with FRS-CVD performing best in women and PCE-WH in men.
May warrant sex-specific PCE recalibration in Koreans; leaves open prospective validation of adjusted models.
BACKGROUND: To investigate the performance of the 2013 American College of Cardiology/American Heart Association Pooled Cohort Equations (PCE) in a large, prospective, community-based cohort in Korea and to compare it with that of the Framingham Global Cardiovascular Disease Risk Score (FRS-CVD) and the Korean Risk Prediction Model (KRPM). METHODS: In the Korean Genome and Epidemiology Study (KOGES)-Ansan and Ansung study, we evaluated calibration and discrimination of the PCE for non-Hispanic whites (PCE-WH) and for African Americans (PCE-AA) and compared their predictive abilities with the FRS-CVD and the KRPM. RESULTS: The present study included 7,932 individuals (3,778 men and 4,154 women). The PCE-WH and PCE-AA moderately overestimated the risk of atherosclerotic cardiovascular disease (ASCVD) for men (6% and 13%, respectively) but underestimated the risk for women (-49% and -25%, respectively). The FRS-CVD overestimated ASCVD risk for men (91%) but provided a good risk prediction for women (3%). The KRPM underestimated ASCVD risk for men (-31%) and women (-31%). All the risk prediction models showed good discrimination in both men (C-statistic 0.730 to 0.735) and women (C-statistic 0.726 to 0.732). Recalibration of the PCE using data from the KOGES-Ansan and Ansung study substantially improved the predictive accuracy in men. CONCLUSION: In the KOGES-Ansan and Ansung study, the PCE overestimated ASCVD risk for men and underestimated the risk for women. The PCE-WH and the FRS-CVD provided an accurate prediction of ASCVD in men and women, respectively.
No takes yet. Share an insight, caveat, or question.
Bae et al. (2020) conducted a cohort in Atherosclerotic cardiovascular disease (ASCVD) (n=7,932). Pooled Cohort Equations (PCE) vs. Framingham Global Cardiovascular Disease Risk Score (FRS-CVD) and Korean Risk Prediction Model (KRPM) was evaluated on Calibration and discrimination (C-statistic) for 10-year ASCVD risk prediction. The Pooled Cohort Equations overestimated 10-year ASCVD risk for men by 6-13% and underestimated it for women by 25-49%, though all evaluated models demonstrated good discrimination with C-statistics ranging from 0.726 to 0.735.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: