Validation of the european SCORE risk chart in the healthy middle-aged Japanese

Mitsuaki Sawano, Shun Kosaka, Tomonori Okamura, Taku Inohara, Daisuke Sugiyama, Makoto Watanabe, Yasuyuki Nakamura, Aya Higashiyama, Aya Kadota, Nagako Okud, Yoshitaka Murakami, Takayoshi Ohkubo, Akira Fujiyoshi, Katsuyuki Miura, Akira Okayama, Hirotsugu Ueshima

Research output: Contribution to journalArticle

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Abstract

Background and aims The European Society of Cardiology developed prediction models (SCORE) for low- and high-risk populations in the European countries. However, whether or not these models are valid in different ethnicities is unknown. We aimed to evaluate the performance of the low-risk SCORE model in the general Japanese population. Methods Healthy middle-aged Japanese participating in the NIPPON DATA80 cohort had been observed. The predicted 10-year cardiovascular death risk was calculated using the low-risk SCORE model for the overall population as well as for each gender individually. The model performance of the low-risk SCORE model was evaluated with the Harrel's c-statistics for discrimination and the Grønnesby and Borgan goodness-of-fit test for calibration. Results A total of 4842 participants aged 40–64 years old and 47,606 person-years were evaluated in our study. 203 (4.19%) died within the ten-years of follow-up and 44 (0.91%) CV deaths were observed. The low-risk SCORE model in the overall population had reasonable discrimination (c statistics 0.72, 95% CI 0.71–0.73) but poor calibration (R2, 0.67, Chi-square value 6.15, p = 0.01). Discrimination was reasonable in both men (c statistics 0.71, 95% CI 0.69–0.73) and women (c statistics 0.71, 95% CI 0.70–0.73). However, calibration was poor in men (R2, 0.22, Chi-square value 0.749, p = 0.38) compared to women (R2, 0.96, Chi-square value 1.39, p = 0.24). Conclusions Although the low-risk SCORE model performs reasonably well in women, the SCORE models generally overestimated the risk of cardiovascular death risk in the Japanese general population.

Original languageEnglish
Pages (from-to)116-121
Number of pages6
JournalAtherosclerosis
Volume252
DOIs
Publication statusPublished - 2016 Sep 1

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Calibration
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Keywords

  • External validation
  • General population
  • Primary prevention
  • Risk score

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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Validation of the european SCORE risk chart in the healthy middle-aged Japanese. / Sawano, Mitsuaki; Kosaka, Shun; Okamura, Tomonori; Inohara, Taku; Sugiyama, Daisuke; Watanabe, Makoto; Nakamura, Yasuyuki; Higashiyama, Aya; Kadota, Aya; Okud, Nagako; Murakami, Yoshitaka; Ohkubo, Takayoshi; Fujiyoshi, Akira; Miura, Katsuyuki; Okayama, Akira; Ueshima, Hirotsugu.

In: Atherosclerosis, Vol. 252, 01.09.2016, p. 116-121.

Research output: Contribution to journalArticle

Sawano, M, Kosaka, S, Okamura, T, Inohara, T, Sugiyama, D, Watanabe, M, Nakamura, Y, Higashiyama, A, Kadota, A, Okud, N, Murakami, Y, Ohkubo, T, Fujiyoshi, A, Miura, K, Okayama, A & Ueshima, H 2016, 'Validation of the european SCORE risk chart in the healthy middle-aged Japanese', Atherosclerosis, vol. 252, pp. 116-121. https://doi.org/10.1016/j.atherosclerosis.2016.07.926
Sawano, Mitsuaki ; Kosaka, Shun ; Okamura, Tomonori ; Inohara, Taku ; Sugiyama, Daisuke ; Watanabe, Makoto ; Nakamura, Yasuyuki ; Higashiyama, Aya ; Kadota, Aya ; Okud, Nagako ; Murakami, Yoshitaka ; Ohkubo, Takayoshi ; Fujiyoshi, Akira ; Miura, Katsuyuki ; Okayama, Akira ; Ueshima, Hirotsugu. / Validation of the european SCORE risk chart in the healthy middle-aged Japanese. In: Atherosclerosis. 2016 ; Vol. 252. pp. 116-121.
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abstract = "Background and aims The European Society of Cardiology developed prediction models (SCORE) for low- and high-risk populations in the European countries. However, whether or not these models are valid in different ethnicities is unknown. We aimed to evaluate the performance of the low-risk SCORE model in the general Japanese population. Methods Healthy middle-aged Japanese participating in the NIPPON DATA80 cohort had been observed. The predicted 10-year cardiovascular death risk was calculated using the low-risk SCORE model for the overall population as well as for each gender individually. The model performance of the low-risk SCORE model was evaluated with the Harrel's c-statistics for discrimination and the Gr{\o}nnesby and Borgan goodness-of-fit test for calibration. Results A total of 4842 participants aged 40–64 years old and 47,606 person-years were evaluated in our study. 203 (4.19{\%}) died within the ten-years of follow-up and 44 (0.91{\%}) CV deaths were observed. The low-risk SCORE model in the overall population had reasonable discrimination (c statistics 0.72, 95{\%} CI 0.71–0.73) but poor calibration (R2, 0.67, Chi-square value 6.15, p = 0.01). Discrimination was reasonable in both men (c statistics 0.71, 95{\%} CI 0.69–0.73) and women (c statistics 0.71, 95{\%} CI 0.70–0.73). However, calibration was poor in men (R2, 0.22, Chi-square value 0.749, p = 0.38) compared to women (R2, 0.96, Chi-square value 1.39, p = 0.24). Conclusions Although the low-risk SCORE model performs reasonably well in women, the SCORE models generally overestimated the risk of cardiovascular death risk in the Japanese general population.",
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T1 - Validation of the european SCORE risk chart in the healthy middle-aged Japanese

AU - Sawano, Mitsuaki

AU - Kosaka, Shun

AU - Okamura, Tomonori

AU - Inohara, Taku

AU - Sugiyama, Daisuke

AU - Watanabe, Makoto

AU - Nakamura, Yasuyuki

AU - Higashiyama, Aya

AU - Kadota, Aya

AU - Okud, Nagako

AU - Murakami, Yoshitaka

AU - Ohkubo, Takayoshi

AU - Fujiyoshi, Akira

AU - Miura, Katsuyuki

AU - Okayama, Akira

AU - Ueshima, Hirotsugu

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Background and aims The European Society of Cardiology developed prediction models (SCORE) for low- and high-risk populations in the European countries. However, whether or not these models are valid in different ethnicities is unknown. We aimed to evaluate the performance of the low-risk SCORE model in the general Japanese population. Methods Healthy middle-aged Japanese participating in the NIPPON DATA80 cohort had been observed. The predicted 10-year cardiovascular death risk was calculated using the low-risk SCORE model for the overall population as well as for each gender individually. The model performance of the low-risk SCORE model was evaluated with the Harrel's c-statistics for discrimination and the Grønnesby and Borgan goodness-of-fit test for calibration. Results A total of 4842 participants aged 40–64 years old and 47,606 person-years were evaluated in our study. 203 (4.19%) died within the ten-years of follow-up and 44 (0.91%) CV deaths were observed. The low-risk SCORE model in the overall population had reasonable discrimination (c statistics 0.72, 95% CI 0.71–0.73) but poor calibration (R2, 0.67, Chi-square value 6.15, p = 0.01). Discrimination was reasonable in both men (c statistics 0.71, 95% CI 0.69–0.73) and women (c statistics 0.71, 95% CI 0.70–0.73). However, calibration was poor in men (R2, 0.22, Chi-square value 0.749, p = 0.38) compared to women (R2, 0.96, Chi-square value 1.39, p = 0.24). Conclusions Although the low-risk SCORE model performs reasonably well in women, the SCORE models generally overestimated the risk of cardiovascular death risk in the Japanese general population.

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KW - External validation

KW - General population

KW - Primary prevention

KW - Risk score

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