Kasim, Sazzli Shahlan and Ibrahim, Nurulain and Malek, Sorayya and Ibrahim, Khairul Shafiq and Aziz, Muhammad Firdaus and Song, Cheen and Chia, Yook Chin and Ramli, Anis Safura and Negishi, Kazuaki and Nasir, Nafiza Mat (2023) Validation of the general Framingham Risk Score (FRS) , SCORE2, revised PCE and WHO CVD risk scores in an Asian population. Lancet Regional Health-Western Pacific, 35. ISSN 2666-6065, DOI https://doi.org/10.1016/j.lanwpc.2023.100742.
Full text not available from this repository.Abstract
Background Cardiovascular risk prediction models incorporate myriad CVD risk factors. Current prediction models are developed from non-Asian populations, and their utility in other parts of the world is unknown. We validated and compared the performance of CVD risk prediction models in an Asian population.Methods Four validation groups were extracted from a longitudinal community-based study dataset of 12,573 participants aged & GE;18 years to validate the Framingham Risk Score (FRS), Systematic COronary Risk Evaluation 2 (SCORE2), Revised Pooled Cohort Equations (RPCE), and World Health Organization cardiovascular disease (WHO CVD) models. Two measures of validation are examined: discrimination and calibration. Outcome of interest was 10-year risk of CVD events (fatal and non-fatal). SCORE2 and RPCE performances were compared to SCORE and PCE, respectively. Findings FRS (AUC = 0.750) and RPCE (AUC = 0.752) showed good discrimination in CVD risk prediction. Although FRS and RPCE have poor calibration, FRS demonstrates smaller discordance for FRS vs. RPCE (298% vs. 733% in men, 146% vs. 391% in women). Other models had reasonable discrimination (AUC = 0.706-0.732). Only SCORE2-Low,-Moderate and-High (aged <50) had good calibration (X2 goodness-of -fit, P-value = 0.514, 0.189, 0.129, respectively). SCORE2 and RPCE showed improvements compared to SCORE (AUC = 0.755 vs. 0.747, P-value <0.001) and PCE (AUC = 0.752 vs. 0.546, P-value <0.001), respectively. Almost all risk models overestimated 10 -year CVD risk by 3%-1430%.Interpretation In Malaysians, RPCE are evaluated be the most clinically useful to predict CVD risk. Additionally, SCORE2 and RPCE outperformed SCORE and PCE, respectively.Funding This work was supported by the Malaysian Ministry of Science, Technology, and Innovation (MOSTI) (Grant No: TDF03211036).Copyright & COPY; 2023 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
| Item Type: | Article |
|---|---|
| Funders: | Ministry of Energy, Science, Technology, Environment and Climate Change (MESTECC), Malaysia (TDF03211036) |
| Uncontrolled Keywords: | Cardiovascular disease; Risk prediction model; Asian; SCORE2; Revised PCE; WHO CVD risk score |
| Subjects: | R Medicine > RA Public aspects of medicine |
| Divisions: | Faculty of Medicine > Primary Care Medicine Department Faculty of Science > Institute of Biological Sciences |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 30 Jul 2025 02:34 |
| Last Modified: | 30 Jul 2025 02:34 |
| URI: | http://eprints.um.edu.my/id/eprint/50739 |
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