Gyung-Min Park1, Seungbong Han1, Seon Ha Kim1, Min-Woo Jo1, Sung Ho Her1, Jung Bok Lee1, Moo Song Lee1, Hyeon Chang Kim1, Jung-Min Ahn1, Seung-Whan Lee1, Young-Hak Kim2, Beom-Jun Kim1, Jung-Min Koh1, Hong-Kyu Kim1, Jaewon Choe2, Seong-Wook Park1, Seung-Jung Park1. 1. From the Department of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea (G.-M.P., S.H.H.); Departments of Biostatistics (S.H., J.B.L., M.S.L.), Preventive Medicine (M.-W.J.), Cardiology, (J.-M.A., S.-W.L., Y.-H.K., S.-W.P., S,-J.P.), Endocrinology and Metabolism (B.-J.K., J.-M.K.), and Health Screening and Promotion Center (H.-K.K., J.C.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Department of Nursing, College of Medicine, Dankook University, Cheonan, Korea (S.H.K.); Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea (H.C.K.); and Research and Development Center, Health Insurance Review and Assessment Service, Seoul, Korea (H.C.K.). 2. From the Department of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea (G.-M.P., S.H.H.); Departments of Biostatistics (S.H., J.B.L., M.S.L.), Preventive Medicine (M.-W.J.), Cardiology, (J.-M.A., S.-W.L., Y.-H.K., S.-W.P., S,-J.P.), Endocrinology and Metabolism (B.-J.K., J.-M.K.), and Health Screening and Promotion Center (H.-K.K., J.C.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Department of Nursing, College of Medicine, Dankook University, Cheonan, Korea (S.H.K.); Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea (H.C.K.); and Research and Development Center, Health Insurance Review and Assessment Service, Seoul, Korea (H.C.K.). mdyhkim@amc.seoul.kr drchoe@hotmail.com.
Abstract
BACKGROUND: A model for predicting cardiovascular disease in Asian populations is limited. METHODS AND RESULTS: In total, 57 393 consecutive asymptomatic Korean individuals aged 30 to 80 years without a prior history of cardiovascular disease who underwent a general health examination were enrolled. Subjects were randomly classified into the train (n=45 914) and validation (n=11 479) cohorts. Thirty-one possible risk factors were assessed. The cardiovascular event was a composite of cardiovascular death, myocardial infarction, and stroke. In the train cohort, the C-index (95% confidence interval) and Akaike Information Criterion were used to develop the best-fitting prediction model. In the validation cohort, the predicted versus the observed cardiovascular event rates were compared by the C-index and Nam and D'Agostino χ(2) statistics. During a median follow-up period of 3.1 (interquartile range, 1.9-4.3) years, 458 subjects had 474 cardiovascular events. In the train cohort, the best-fitting model consisted of age, diabetes mellitus, hypertension, current smoking, family history of coronary heart disease, white blood cell, creatinine, glycohemoglobin, atrial fibrillation, blood pressure, and cholesterol (C-index =0.757 [0.726-0.788] and Akaike Information Criterion =7207). When this model was tested in the validation cohort, it performed well in terms of discrimination and calibration abilities (C-index=0.760 [0.693-0.828] and Nam and D'Agostino χ(2) statistic =0.001 for 3 years; C-index=0.782 [0.719-0.846] and Nam and D'Agostino χ(2) statistic=1.037 for 5 years). CONCLUSIONS: A risk model based on traditional clinical and biomarkers has a feasible model performance in predicting cardiovascular events in an asymptomatic Korean population.
RCT Entities:
BACKGROUND: A model for predicting cardiovascular disease in Asian populations is limited. METHODS AND RESULTS: In total, 57 393 consecutive asymptomatic Korean individuals aged 30 to 80 years without a prior history of cardiovascular disease who underwent a general health examination were enrolled. Subjects were randomly classified into the train (n=45 914) and validation (n=11 479) cohorts. Thirty-one possible risk factors were assessed. The cardiovascular event was a composite of cardiovascular death, myocardial infarction, and stroke. In the train cohort, the C-index (95% confidence interval) and Akaike Information Criterion were used to develop the best-fitting prediction model. In the validation cohort, the predicted versus the observed cardiovascular event rates were compared by the C-index and Nam and D'Agostino χ(2) statistics. During a median follow-up period of 3.1 (interquartile range, 1.9-4.3) years, 458 subjects had 474 cardiovascular events. In the train cohort, the best-fitting model consisted of age, diabetes mellitus, hypertension, current smoking, family history of coronary heart disease, white blood cell, creatinine, glycohemoglobin, atrial fibrillation, blood pressure, and cholesterol (C-index =0.757 [0.726-0.788] and Akaike Information Criterion =7207). When this model was tested in the validation cohort, it performed well in terms of discrimination and calibration abilities (C-index=0.760 [0.693-0.828] and Nam and D'Agostino χ(2) statistic =0.001 for 3 years; C-index=0.782 [0.719-0.846] and Nam and D'Agostino χ(2) statistic=1.037 for 5 years). CONCLUSIONS: A risk model based on traditional clinical and biomarkers has a feasible model performance in predicting cardiovascular events in an asymptomatic Korean population.
Authors: Bharath Ambale-Venkatesh; Xiaoying Yang; Colin O Wu; Kiang Liu; W Gregory Hundley; Robyn McClelland; Antoinette S Gomes; Aaron R Folsom; Steven Shea; Eliseo Guallar; David A Bluemke; João A C Lima Journal: Circ Res Date: 2017-08-09 Impact factor: 17.367
Authors: Seungbong Han; Gyung Min Park; Yong Giun Kim; Mahn Won Park; Sung Ho Her; Seung Whan Lee; Young Hak Kim Journal: Korean Circ J Date: 2018-04 Impact factor: 3.243