Predicting the Ten-Year Risks of Atherosclerotic Cardiovascular Disease in Chinese Population: The China-PAR Project
Background—The accurate assessment of individual risk can be of great value to guiding and facilitating prevention of atherosclerotic cardiovascular disease (ASCVD). However, prediction models in common use were primarily formulated in white populations. The project is aimed to develop and validate ten-year risk prediction equations for ASCVD from four contemporary Chinese cohorts.
Methods—Two prospective studies followed up together with a unified protocol were used as the derivation cohort to develop 10-year ASCVD risk equations in 21 320 Chinese participants. The external validation was evaluated in two independent Chinese cohorts with 14 123 and 70 838 participants. Furthermore, the model performance was compared with the Pooled Cohort Equations (PCE) reported in the American College of Cardiology/American Heart Association (ACC/AHA) guideline.
Results—Over 12 years of follow-up in the derivation cohort with 21 320 Chinese participants, 1048 subjects developed a first ASCVD event. Gender-specific equations had C-statistics of 0.794 (95% CI, 0.775-0.814) for men and 0.811 (95% CI, 0.787-0.835) for women, respectively. The predicted rates were similar with the observed rates, as indicated by calibration χ² of 13.1 for men (P＝0.16) and of 12.8 for women (P＝0.17). Good internal and external validations of our equations were achieved in subsequent analyses. Compared with the Chinese equations, the PCE had lower C-statistics and much higher calibration χ² in men.
Conclusions—Our project developed effective tools with good performance for ten-year ASCVD risk prediction among Chinese population, which will help to improve primary prevention and management of cardiovascular disease.
- Received March 4, 2016.
- Revision received August 3, 2016.
- Accepted August 23, 2016.