The predictive accuracy of coronary heart disease risk prediction models in rural Northwestern China
Cardiovascular risk models developed may have limitations when applied to rural Chinese. This study validated and compared the Framingham Risk Score (FRS) and Prediction for Atherosclerotic Cardiovascular Disease Risk in China (PAR) models in predicting 10-year risk of coronary heart disease (CHD) i...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-12-01
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| Series: | Preventive Medicine Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2211335523003947 |
| _version_ | 1797615903593988096 |
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| author | Jiangwei Qiu Zhenqi Chang Kai Wang Kexin Chen Qingan Wang Jiaxing Zhang Juan Li Chan Yang Yi Zhao Yuhong Zhang |
| author_facet | Jiangwei Qiu Zhenqi Chang Kai Wang Kexin Chen Qingan Wang Jiaxing Zhang Juan Li Chan Yang Yi Zhao Yuhong Zhang |
| author_sort | Jiangwei Qiu |
| collection | DOAJ |
| description | Cardiovascular risk models developed may have limitations when applied to rural Chinese. This study validated and compared the Framingham Risk Score (FRS) and Prediction for Atherosclerotic Cardiovascular Disease Risk in China (PAR) models in predicting 10-year risk of coronary heart disease (CHD) in a rural cohort in Ningxia, China from 2008 to 2019. The FRS and PAR models were validated by estimating predicted events, C index, calibration χ2 and plots. 1381 adults without CHD at baseline were followed up for 9.75 years on average. 168 CHD cases were observed. The FRS and PAR underestimated CHD events by 22 % and 46 % for the total population, while overestimated for males by 152 % and 78 %, respectively. The C index was slightly higher for PAR than FRS. Both models showed weak calibration with chi-square values above 20 (p < 0.001). Bland-Altman plots indicated FRS predicted higher CHD risk than PAR, lacking consistency. Overall, FRS and PAR demonstrated limited performance in predicting 10-year CHD risk in this rural population. PAR had slightly better discrimination than FRS, but require further improvement in calibration and individual risk estimation to suit the rural population in Northwest China. |
| first_indexed | 2024-03-11T07:33:35Z |
| format | Article |
| id | doaj.art-168a1d0a27c74db3b9ad12907356ef4c |
| institution | Directory Open Access Journal |
| issn | 2211-3355 |
| language | English |
| last_indexed | 2024-03-11T07:33:35Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Preventive Medicine Reports |
| spelling | doaj.art-168a1d0a27c74db3b9ad12907356ef4c2023-11-17T05:26:14ZengElsevierPreventive Medicine Reports2211-33552023-12-0136102503The predictive accuracy of coronary heart disease risk prediction models in rural Northwestern ChinaJiangwei Qiu0Zhenqi Chang1Kai Wang2Kexin Chen3Qingan Wang4Jiaxing Zhang5Juan Li6Chan Yang7Yi Zhao8Yuhong Zhang9School of Public, Ningxia Medical University, Yinchuan, China; NHC Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan, ChinaSchool of Public, Ningxia Medical University, Yinchuan, ChinaSchool of Public, Ningxia Medical University, Yinchuan, China; The Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, ChinaSchool of Public, Ningxia Medical University, Yinchuan, ChinaSchool of Public, Ningxia Medical University, Yinchuan, China; The Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, ChinaSchool of Public, Ningxia Medical University, Yinchuan, China; The Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, ChinaSchool of Public, Ningxia Medical University, Yinchuan, ChinaSchool of Public, Ningxia Medical University, Yinchuan, China; Department of Community Nursing, School of Nursing, Ningxia Medical University, Yinchuan, ChinaSchool of Public, Ningxia Medical University, Yinchuan, China; NHC Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan, China; The Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, China; Corresponding authors at: Department of Nutrition and Food Hygiene, School of Public Health, Ningxia Medical University, 1160 Shengli Street, Xingqing District, Yinchuan, Ningxia Hui Autonomous Region, China (Yi Zhao). Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, 1160 Shengli Street, Xingqing District, Yinchuan, Ningxia Hui Autonomous Region, China (Yuhong Zhang).School of Public, Ningxia Medical University, Yinchuan, China; NHC Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan, China; The Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, China; Corresponding authors at: Department of Nutrition and Food Hygiene, School of Public Health, Ningxia Medical University, 1160 Shengli Street, Xingqing District, Yinchuan, Ningxia Hui Autonomous Region, China (Yi Zhao). Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, 1160 Shengli Street, Xingqing District, Yinchuan, Ningxia Hui Autonomous Region, China (Yuhong Zhang).Cardiovascular risk models developed may have limitations when applied to rural Chinese. This study validated and compared the Framingham Risk Score (FRS) and Prediction for Atherosclerotic Cardiovascular Disease Risk in China (PAR) models in predicting 10-year risk of coronary heart disease (CHD) in a rural cohort in Ningxia, China from 2008 to 2019. The FRS and PAR models were validated by estimating predicted events, C index, calibration χ2 and plots. 1381 adults without CHD at baseline were followed up for 9.75 years on average. 168 CHD cases were observed. The FRS and PAR underestimated CHD events by 22 % and 46 % for the total population, while overestimated for males by 152 % and 78 %, respectively. The C index was slightly higher for PAR than FRS. Both models showed weak calibration with chi-square values above 20 (p < 0.001). Bland-Altman plots indicated FRS predicted higher CHD risk than PAR, lacking consistency. Overall, FRS and PAR demonstrated limited performance in predicting 10-year CHD risk in this rural population. PAR had slightly better discrimination than FRS, but require further improvement in calibration and individual risk estimation to suit the rural population in Northwest China.http://www.sciencedirect.com/science/article/pii/S2211335523003947Coronary heart diseaseRisk assessmentPrediction modelExternal validationRural population |
| spellingShingle | Jiangwei Qiu Zhenqi Chang Kai Wang Kexin Chen Qingan Wang Jiaxing Zhang Juan Li Chan Yang Yi Zhao Yuhong Zhang The predictive accuracy of coronary heart disease risk prediction models in rural Northwestern China Preventive Medicine Reports Coronary heart disease Risk assessment Prediction model External validation Rural population |
| title | The predictive accuracy of coronary heart disease risk prediction models in rural Northwestern China |
| title_full | The predictive accuracy of coronary heart disease risk prediction models in rural Northwestern China |
| title_fullStr | The predictive accuracy of coronary heart disease risk prediction models in rural Northwestern China |
| title_full_unstemmed | The predictive accuracy of coronary heart disease risk prediction models in rural Northwestern China |
| title_short | The predictive accuracy of coronary heart disease risk prediction models in rural Northwestern China |
| title_sort | predictive accuracy of coronary heart disease risk prediction models in rural northwestern china |
| topic | Coronary heart disease Risk assessment Prediction model External validation Rural population |
| url | http://www.sciencedirect.com/science/article/pii/S2211335523003947 |
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