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Validation of the Framingham general cardiovascular risk score in a multiethnic Asian population: a retrospective cohort study
OBJECTIVE: This study aims to examine the validity of the Framingham general cardiovascular disease (CVD) risk chart in a primary care setting. DESIGN: This is a 10-year retrospective cohort study. SETTING: A primary care clinic in a teaching hospital in Malaysia. PARTICIPANTS: 967 patients’ records...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4442208/ https://www.ncbi.nlm.nih.gov/pubmed/25991451 http://dx.doi.org/10.1136/bmjopen-2014-007324 |
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author | Chia, Yook Chin Gray, Sarah Yu Weng Ching, Siew Mooi Lim, Hooi Min Chinna, Karuthan |
author_facet | Chia, Yook Chin Gray, Sarah Yu Weng Ching, Siew Mooi Lim, Hooi Min Chinna, Karuthan |
author_sort | Chia, Yook Chin |
collection | PubMed |
description | OBJECTIVE: This study aims to examine the validity of the Framingham general cardiovascular disease (CVD) risk chart in a primary care setting. DESIGN: This is a 10-year retrospective cohort study. SETTING: A primary care clinic in a teaching hospital in Malaysia. PARTICIPANTS: 967 patients’ records were randomly selected from patients who were attending follow-up in the clinic. MAIN OUTCOME MEASURES: Baseline demographic data, history of diabetes and smoking, blood pressure (BP), and serum lipids were captured from patient records in 1998. Each patient's Framingham CVD score was computed from these parameters. All atherosclerotic CVD events occurring between 1998 and 2007 were counted. RESULTS: In 1998, mean age was 57 years with 33.8% men, 6.1% smokers, 43.3% diabetics and 59.7% hypertensive. Median BP was 140/80 mm Hg and total cholesterol 6.0 mmol/L (1.3). The predicted median Framingham general CVD risk score for the study population was 21.5% (IQR 1.2–30.0) while the actual CVD events that occurred in the 10 years was 13.1% (127/967). The median CVD points for men was 30.0, giving them a CVD risk of more than 30%; for women it is 18.5, a CVD risk of 21.5%. Our study found that the Framingham general CVD risk score to have moderate discrimination with an area under the receiver operating characteristic curve (AUC) of 0.63. It also discriminates well for Malay (AUC 0.65, p=0.01), Chinese (AUC 0.60, p=0.03), and Indians (AUC 0.65, p=0.001). There was good calibration with Hosmer-Lemeshow test χ(2)=3.25, p=0.78. CONCLUSIONS: Taking into account that this cohort of patients were already on treatment, the Framingham General CVD Risk Prediction Score predicts fairly accurately for men and overestimates somewhat for women. In the absence of local risk prediction charts, the Framingham general CVD risk prediction chart is a reasonable alternative for use in a multiethnic group in a primary care setting. |
format | Online Article Text |
id | pubmed-4442208 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-44422082015-05-28 Validation of the Framingham general cardiovascular risk score in a multiethnic Asian population: a retrospective cohort study Chia, Yook Chin Gray, Sarah Yu Weng Ching, Siew Mooi Lim, Hooi Min Chinna, Karuthan BMJ Open Cardiovascular Medicine OBJECTIVE: This study aims to examine the validity of the Framingham general cardiovascular disease (CVD) risk chart in a primary care setting. DESIGN: This is a 10-year retrospective cohort study. SETTING: A primary care clinic in a teaching hospital in Malaysia. PARTICIPANTS: 967 patients’ records were randomly selected from patients who were attending follow-up in the clinic. MAIN OUTCOME MEASURES: Baseline demographic data, history of diabetes and smoking, blood pressure (BP), and serum lipids were captured from patient records in 1998. Each patient's Framingham CVD score was computed from these parameters. All atherosclerotic CVD events occurring between 1998 and 2007 were counted. RESULTS: In 1998, mean age was 57 years with 33.8% men, 6.1% smokers, 43.3% diabetics and 59.7% hypertensive. Median BP was 140/80 mm Hg and total cholesterol 6.0 mmol/L (1.3). The predicted median Framingham general CVD risk score for the study population was 21.5% (IQR 1.2–30.0) while the actual CVD events that occurred in the 10 years was 13.1% (127/967). The median CVD points for men was 30.0, giving them a CVD risk of more than 30%; for women it is 18.5, a CVD risk of 21.5%. Our study found that the Framingham general CVD risk score to have moderate discrimination with an area under the receiver operating characteristic curve (AUC) of 0.63. It also discriminates well for Malay (AUC 0.65, p=0.01), Chinese (AUC 0.60, p=0.03), and Indians (AUC 0.65, p=0.001). There was good calibration with Hosmer-Lemeshow test χ(2)=3.25, p=0.78. CONCLUSIONS: Taking into account that this cohort of patients were already on treatment, the Framingham General CVD Risk Prediction Score predicts fairly accurately for men and overestimates somewhat for women. In the absence of local risk prediction charts, the Framingham general CVD risk prediction chart is a reasonable alternative for use in a multiethnic group in a primary care setting. BMJ Publishing Group 2015-05-19 /pmc/articles/PMC4442208/ /pubmed/25991451 http://dx.doi.org/10.1136/bmjopen-2014-007324 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
spellingShingle | Cardiovascular Medicine Chia, Yook Chin Gray, Sarah Yu Weng Ching, Siew Mooi Lim, Hooi Min Chinna, Karuthan Validation of the Framingham general cardiovascular risk score in a multiethnic Asian population: a retrospective cohort study |
title | Validation of the Framingham general cardiovascular risk score in a multiethnic Asian population: a retrospective cohort study |
title_full | Validation of the Framingham general cardiovascular risk score in a multiethnic Asian population: a retrospective cohort study |
title_fullStr | Validation of the Framingham general cardiovascular risk score in a multiethnic Asian population: a retrospective cohort study |
title_full_unstemmed | Validation of the Framingham general cardiovascular risk score in a multiethnic Asian population: a retrospective cohort study |
title_short | Validation of the Framingham general cardiovascular risk score in a multiethnic Asian population: a retrospective cohort study |
title_sort | validation of the framingham general cardiovascular risk score in a multiethnic asian population: a retrospective cohort study |
topic | Cardiovascular Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4442208/ https://www.ncbi.nlm.nih.gov/pubmed/25991451 http://dx.doi.org/10.1136/bmjopen-2014-007324 |
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