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Schiborn, C.* ; Kuhn, T.* ; Mühlenbruch, K.* ; Kuxhaus, O.* ; Weikert, C.* ; Fritsche, A. ; Kaaks, R.* ; Schulze, M.B.*

A newly developed and externally validated non-clinical score accurately predicts 10-year cardiovascular disease risk in the general adult population.

Sci. Rep. 11:19609 (2021)

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Inclusion of clinical parameters limits the application of most cardiovascular disease (CVD) prediction models to clinical settings. We developed and externally validated a non-clinical CVD risk score with a clinical extension and compared the performance to established CVD risk scores. We derived the scores predicting CVD (non-fatal and fatal myocardial infarction and stroke) in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam cohort (n = 25,992, cases = 683) using competing risk models and externally validated in EPIC-Heidelberg (n = 23,529, cases = 692). Performance was assessed by C-indices, calibration plots, and expected-to-observed ratios and compared to a non-clinical model, the Pooled Cohort Equation, Framingham CVD Risk Scores (FRS), PROCAM scores, and the Systematic Coronary Risk Evaluation (SCORE). Our non-clinical score included age, gender, waist circumference, smoking, hypertension, type 2 diabetes, CVD family history, and dietary parameters. C-indices consistently indicated good discrimination (EPIC-Potsdam 0.786, EPIC-Heidelberg 0.762) comparable to established clinical scores (thereof highest, FRS: EPIC-Potsdam 0.781, EPIC-Heidelberg 0.764). Additional clinical parameters slightly improved discrimination (EPIC-Potsdam 0.796, EPIC-Heidelberg 0.769). Calibration plots indicated very good calibration with minor overestimation in the highest decile of predicted risk. The developed non-clinical 10-year CVD risk score shows comparable discrimination to established clinical scores, allowing assessment of individual CVD risk in physician-independent settings.

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Publication type Article: Journal article

Document type Scientific Article

Corresponding Author

Keywords Multiple Imputation; Epic-germany; Follow-up; Model; Subdistribution; Association; Stroke; Tool

ISSN (print) / ISBN 2045-2322

e-ISSN 2045-2322

Journal Scientific Reports

Quellenangaben Volume: 11, Issue: 1, Article Number: 19609

Publisher Nature Publishing Group

Publishing Place London

Non-patent literature Publications

Reviewing status Peer reviewed

Institute(s) Institute of Diabetes Research and Metabolic Diseases (IDM)

Grants German Cancer Research Center (DKFZ)
Federal Ministry of Science, Germany
European Union
German Cancer Aid
German Federal Ministry of Education and Research
German Federal Ministry of Education and Research through the German Center for Diabetes Research
State of Brandenburg through the German Center for Diabetes Research
Projekt DEAL