Comparing the Consistency and Performance of Various Coronary Heart Disease Prediction Models for Primary Prevention Using a National Representative Cohort in Taiwan

Circ J. 2018 Jun 25;82(7):1805-1812. doi: 10.1253/circj.CJ-17-0910. Epub 2018 Apr 27.

Abstract

Background: Predicting future coronary artery disease (CAD) risk by model-based approaches can facilitate identification of high-risk individuals for prevention and management. Therefore, we compared the consistency and performance of various CAD models for primary prevention using 1 external validation dataset from a national representative cohort in Taiwan.Methods and Results:The 10 CAD prediction models were assessed in a validation cohort of 3559 participants (≥35 years old, 53.5% women) from a Taiwanese national representative cohort that was followed up for a median 9.70 (interquartile range, 9.63-9.74) years; 63 cases were documented as developing CAD events. The overall κ value was 0.51 for all 10 models, with a higher value for women than for men (0.53 for women, 0.40 for men). In addition, the areas under the receiver operating characteristics curves ranged from 0.804 (95% confidence interval, 0.758-0.851) to 0.847 (95% confidence interval, 0.805-0.889). All non-significant chi-square values indicated good calibration ability.

Conclusions: Our study demonstrated these 10 CAD prediction models for primary prevention were feasible and validated for use in Taiwanese subjects. Further studies of screening and management are warranted.

Keywords: Coronary artery disease; Prediction models; Primary prevention.

MeSH terms

  • Adult
  • Cohort Studies
  • Coronary Artery Disease / epidemiology
  • Coronary Artery Disease / prevention & control*
  • Disease Management
  • Female
  • Humans
  • Male
  • Middle Aged
  • Models, Cardiovascular*
  • Predictive Value of Tests*
  • Primary Prevention
  • ROC Curve
  • Risk Assessment
  • Taiwan / epidemiology