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Development of new scores for atherosclerotic cardiovascular disease using specific medical examination items: the Suita Study

BACKGROUND: We previously developed risk models predicting stroke, coronary heart disease (CHD), and cardiovascular disease (CVD) among Japanese people from the Suita Study. Yet, applying these models at the national level was challenging because some of the included risk factors differed from those...

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Autores principales: Arafa, Ahmed, Kashima, Rena, Yasui, Yuka, Kawachi, Haruna, Matsumoto, Chisa, Nosaka, Saya, Teramoto, Masayuki, Matsuo, Miki, Kokubo, Yoshihiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Japanese Society for Hygiene 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10613553/
https://www.ncbi.nlm.nih.gov/pubmed/37899208
http://dx.doi.org/10.1265/ehpm.23-00099
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author Arafa, Ahmed
Kashima, Rena
Yasui, Yuka
Kawachi, Haruna
Matsumoto, Chisa
Nosaka, Saya
Teramoto, Masayuki
Matsuo, Miki
Kokubo, Yoshihiro
author_facet Arafa, Ahmed
Kashima, Rena
Yasui, Yuka
Kawachi, Haruna
Matsumoto, Chisa
Nosaka, Saya
Teramoto, Masayuki
Matsuo, Miki
Kokubo, Yoshihiro
author_sort Arafa, Ahmed
collection PubMed
description BACKGROUND: We previously developed risk models predicting stroke, coronary heart disease (CHD), and cardiovascular disease (CVD) among Japanese people from the Suita Study. Yet, applying these models at the national level was challenging because some of the included risk factors differed from those collected in the Japanese governmental health check-ups, such as Tokutei-Kenshin. We, therefore, conducted this study to develop new risk models for stroke, CHD, and atherosclerotic CVD (ASCVD), based on data from the Suita Study. The new models used traditional cardiovascular risk factors similar to those in the Japanese governmental health check-ups. METHODS: We included 7,413 participants, aged 30–84 years, initially free from stroke and CHD. All participants received baseline health examinations, including a questionnaire assessing their lifestyle and medical history, medical examination, and blood and urine analysis. The risk factors of stroke, CHD, and ASCVD (cerebral infarction or CHD) were determined using the multivariable-adjusted Cox regression. The models’ performance was assessed using the C-statistics for discrimination and the Hosmer-Lemeshow for calibration. We also developed three simple scores (zero to 100) that could predict the 10-year incidence of stroke, CHD, and ASCVD. RESULTS: Within 110,428 person-years (median follow-up = 16.6 years), 410 stroke events, 288 CHD events, and 527 ASCVD events were diagnosed. Age, smoking, hypertension, and diabetes were associated with stroke, CHD, and ASCVD risk. Men and those with decreased high-density lipoproteins or increased low-density lipoproteins showed a higher risk of CHD and ASCVD. Urinary proteins were associated with an increased risk of stroke and ASCVD. The C-statistic values of the risk models were >0.750 and the p-values of goodness-of-fit were >0.30. The 10-year incidence of stroke, CVD, and ASCVD events was 3.8%, 3.5%, and 5.7% for scores 45–54, 10.3%, 11.8%, and 19.6% for scores 65–74, and 27.7%, 23.5%, and 60.5% for scores ≥85, respectively. CONCLUSIONS: We developed new Suita risk models for stroke, CHD, and ASCVD using variables similar to those in the Japanese governmental health check-ups. We also developed new risk scores to predict incident stroke, CHD, and ASCVD within 10 years. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at https://doi.org/10.1265/ehpm.23-00099.
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spelling pubmed-106135532023-10-31 Development of new scores for atherosclerotic cardiovascular disease using specific medical examination items: the Suita Study Arafa, Ahmed Kashima, Rena Yasui, Yuka Kawachi, Haruna Matsumoto, Chisa Nosaka, Saya Teramoto, Masayuki Matsuo, Miki Kokubo, Yoshihiro Environ Health Prev Med Research Article BACKGROUND: We previously developed risk models predicting stroke, coronary heart disease (CHD), and cardiovascular disease (CVD) among Japanese people from the Suita Study. Yet, applying these models at the national level was challenging because some of the included risk factors differed from those collected in the Japanese governmental health check-ups, such as Tokutei-Kenshin. We, therefore, conducted this study to develop new risk models for stroke, CHD, and atherosclerotic CVD (ASCVD), based on data from the Suita Study. The new models used traditional cardiovascular risk factors similar to those in the Japanese governmental health check-ups. METHODS: We included 7,413 participants, aged 30–84 years, initially free from stroke and CHD. All participants received baseline health examinations, including a questionnaire assessing their lifestyle and medical history, medical examination, and blood and urine analysis. The risk factors of stroke, CHD, and ASCVD (cerebral infarction or CHD) were determined using the multivariable-adjusted Cox regression. The models’ performance was assessed using the C-statistics for discrimination and the Hosmer-Lemeshow for calibration. We also developed three simple scores (zero to 100) that could predict the 10-year incidence of stroke, CHD, and ASCVD. RESULTS: Within 110,428 person-years (median follow-up = 16.6 years), 410 stroke events, 288 CHD events, and 527 ASCVD events were diagnosed. Age, smoking, hypertension, and diabetes were associated with stroke, CHD, and ASCVD risk. Men and those with decreased high-density lipoproteins or increased low-density lipoproteins showed a higher risk of CHD and ASCVD. Urinary proteins were associated with an increased risk of stroke and ASCVD. The C-statistic values of the risk models were >0.750 and the p-values of goodness-of-fit were >0.30. The 10-year incidence of stroke, CVD, and ASCVD events was 3.8%, 3.5%, and 5.7% for scores 45–54, 10.3%, 11.8%, and 19.6% for scores 65–74, and 27.7%, 23.5%, and 60.5% for scores ≥85, respectively. CONCLUSIONS: We developed new Suita risk models for stroke, CHD, and ASCVD using variables similar to those in the Japanese governmental health check-ups. We also developed new risk scores to predict incident stroke, CHD, and ASCVD within 10 years. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at https://doi.org/10.1265/ehpm.23-00099. Japanese Society for Hygiene 2023-10-27 /pmc/articles/PMC10613553/ /pubmed/37899208 http://dx.doi.org/10.1265/ehpm.23-00099 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Arafa, Ahmed
Kashima, Rena
Yasui, Yuka
Kawachi, Haruna
Matsumoto, Chisa
Nosaka, Saya
Teramoto, Masayuki
Matsuo, Miki
Kokubo, Yoshihiro
Development of new scores for atherosclerotic cardiovascular disease using specific medical examination items: the Suita Study
title Development of new scores for atherosclerotic cardiovascular disease using specific medical examination items: the Suita Study
title_full Development of new scores for atherosclerotic cardiovascular disease using specific medical examination items: the Suita Study
title_fullStr Development of new scores for atherosclerotic cardiovascular disease using specific medical examination items: the Suita Study
title_full_unstemmed Development of new scores for atherosclerotic cardiovascular disease using specific medical examination items: the Suita Study
title_short Development of new scores for atherosclerotic cardiovascular disease using specific medical examination items: the Suita Study
title_sort development of new scores for atherosclerotic cardiovascular disease using specific medical examination items: the suita study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10613553/
https://www.ncbi.nlm.nih.gov/pubmed/37899208
http://dx.doi.org/10.1265/ehpm.23-00099
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