Framingham risk score and alternatives for prediction of coronary heart disease in older adults.

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Version: Final published version
Serval ID
serval:BIB_50F9A5C935B8
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Framingham risk score and alternatives for prediction of coronary heart disease in older adults.
Journal
Plos One
Author(s)
Rodondi N., Locatelli I., Aujesky D., Butler J., Vittinghoff E., Simonsick E., Satterfield S., Newman A.B., Wilson P.W., Pletcher M.J., Bauer D.C.
Working group(s)
Health ABC Study
ISSN
1932-6203 (Electronic)
ISSN-L
1932-6203
Publication state
Published
Issued date
2012
Peer-reviewed
Oui
Volume
7
Number
3
Pages
e34287 [8 p.]
Language
english
Notes
Publication types: Journal Article
Abstract
BACKGROUND: Guidelines for the prevention of coronary heart disease (CHD) recommend use of Framingham-based risk scores that were developed in white middle-aged populations. It remains unclear whether and how CHD risk prediction might be improved among older adults. We aimed to compare the prognostic performance of the Framingham risk score (FRS), directly and after recalibration, with refit functions derived from the present cohort, as well as to assess the utility of adding other routinely available risk parameters to FRS.¦METHODS: Among 2193 black and white older adults (mean age, 73.5 years) without pre-existing cardiovascular disease from the Health ABC cohort, we examined adjudicated CHD events, defined as incident myocardial infarction, CHD death, and hospitalization for angina or coronary revascularization.¦RESULTS: During 8-year follow-up, 351 participants experienced CHD events. The FRS poorly discriminated between persons who experienced CHD events vs. not (C-index: 0.577 in women; 0.583 in men) and underestimated absolute risk prediction by 51% in women and 8% in men. Recalibration of the FRS improved absolute risk prediction, particulary for women. For both genders, refitting these functions substantially improved absolute risk prediction, with similar discrimination to the FRS. Results did not differ between whites and blacks. The addition of lifestyle variables, waist circumference and creatinine did not improve risk prediction beyond risk factors of the FRS.¦CONCLUSIONS: The FRS underestimates CHD risk in older adults, particularly in women, although traditional risk factors remain the best predictors of CHD. Re-estimated risk functions using these factors improve accurate estimation of absolute risk.
Pubmed
Web of science
Open Access
Yes
Create date
03/08/2012 15:28
Last modification date
20/08/2019 14:06
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