Prediction of atherosclerotic cardiovascular disease mortality in a nationally representative cohort using a set of risk factors from pooled cohort risk equations

Details

• Alternative Title:
  PLoS One
• Personal Author:
  Zhang, Zefeng ; Gillespie, Cathleen ; Bowman, Barbara ; Yang, Quanhe
• Description:
  The American College of Cardiology/American Heart Association developed Pooled Cohort equations to estimate atherosclerotic cardiovascular disease (ASCVD) risk. It is unclear how well the equations predict ASCVD mortality in a nationally representative cohort. We used the National Health and Nutrition Examination Survey (NHANES) 1988-1994 and Linked Mortality through 2006 (n = 6,644). Among participants aged 40-79 years without ASCVD at baseline, we used Cox proportional hazard models to estimate the 10-year probability of ASCVD death by sex and race-ethnicity (non-Hispanic white (NHW), non-Hispanic black (NHB) and Mexican American (MA)). We estimated the discrimination and calibration for each sex-race-ethnicity model. We documented 288 ASCVD deaths during 62,335 person years. The Pooled Cohort equations demonstrated moderate to good discrimination for ASCVD mortality, with modified C-statistics of 0.716 (95% CI 0.663-0.770), 0.794 (0.734-0.854), and 0.733 (0.654-0.811) for NHW, NHB and MA men, respectively. The corresponding C-statistics for women were 0.781 (0.718-0.844), 0.702 (0.633-0.771), and 0.789 (CI 0.721-0.857). Modified Hosmer-Lemeshow χ2 suggested adequate calibration for NHW, NHB and MA men, and MA women (p-values: 0.128, 0.295, 0.104 and 0.163 respectively). The calibration was inadequate for NHW and NHB women (p<0.05). In this nationally representative cohort, the Pooled Cohort equations performed adequately to predict 10-year ASCVD mortality for NHW and NHB men, and MA population, but not for NHW and NHB women.
• Subjects:
  Atherosclerosis Cardiovascular Diseases Cohort Studies Female Humans Male Middle Aged Risk Factors
• Source:
  PLoS One. 12(4).
• Pubmed ID:
  28426694
• Pubmed Central ID:
  PMC5398528
• Document Type:
  Journal Article
• Volume:
  12
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:f4d0d42596507ed73376409d2573d42c7db2d0eaff0b4d83b820c587bb7f6a33
• Download URL:
  https://stacks.cdc.gov/view/cdc/45495/cdc_45495_DS1.pdf
• File Type:
  [PDF - 1.52 MB ]