External validation of pooled cohort equations using systolic blood pressure intervention trial data.

Pubmed ID: 31088530

Pubmed Central ID: PMC6518641

Journal: BMC research notes

Publication Date: May 14, 2019

Affiliation: Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77, Higashinaniwa-Cho, Amagasaki, Hyogo, 660-8550, Japan.

Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6518641/pdf/13104_2019_Article_4293.pdf?link_time=2024-06-19_05:59:59.344820

MeSH Terms: Humans, Male, Female, Risk Factors, Cohort Studies, Middle Aged, Blood Pressure, Systole, Atherosclerosis

Authors: Kuragaichi T, Kataoka Y, Miyakoshi C, Miyamoto T, Sato Y

Cite As: Kuragaichi T, Kataoka Y, Miyakoshi C, Miyamoto T, Sato Y. External validation of pooled cohort equations using systolic blood pressure intervention trial data. BMC Res Notes 2019 May 14;12(1):271.

Studies:

Abstract

OBJECTIVE: The risk of atherosclerotic cardiovascular disease (ASCVD) is estimated using the American College of Cardiology (ACC)/American Heart Association (AHA) Pooled Cohort Equations (PCEs). However, the accuracy of this tool remains controversial, particularly among patients who are recommended statin therapy according to the ACC/AHA guidelines. We performed external validation of PCEs among patients eligible for statin therapy using data from the systolic blood pressure intervention trial (SPRINT). RESULTS: Our study included 4057 patients from among the 9361 patients in SPRINT. The mean patient age was 64.5 years, and the median predicted 10-year risks of ASCVD were 17.2% and 12.3% for men and women, respectively. Over a median follow-up of 3.3 years, 133 primary events (including 23 cardiovascular deaths) were noted, whereas 304 events were predicted by the PCEs. The PCEs demonstrated poor calibration (Hosmer-Lemeshow test, p < 0.001) and overestimated the probability consistently. Additionally, they showed moderate discrimination [area under the curve: 0.65 (95% confidence interval, 0.60-0.69)]. This study demonstrates that PCEs might overestimate the risk of ASCVD in patients who are recommended statin therapy.