Carrillo-Larco, Rodrigo M and Stern, Dalia and Hambleton, Ian R and Lotufo, Paulo and Di Cesare, Mariachiara and Hennis, Anselm and Ferreccio, Catterina and Irazola, Vilma and Perel, Pablo and Gregg, Edward W and Miranda, J Jaime and Ezzati, Majid and Danaei, Goodarz (2022) Derivation, internal validation, and recalibration of a cardiovascular risk score for Latin America and the Caribbean (Globorisk-LAC): A pooled analysis of cohort studies. The Lancet Regional Health - Americas, 9. p. 100258. DOI https://doi.org/10.1016/j.lana.2022.100258
Carrillo-Larco, Rodrigo M and Stern, Dalia and Hambleton, Ian R and Lotufo, Paulo and Di Cesare, Mariachiara and Hennis, Anselm and Ferreccio, Catterina and Irazola, Vilma and Perel, Pablo and Gregg, Edward W and Miranda, J Jaime and Ezzati, Majid and Danaei, Goodarz (2022) Derivation, internal validation, and recalibration of a cardiovascular risk score for Latin America and the Caribbean (Globorisk-LAC): A pooled analysis of cohort studies. The Lancet Regional Health - Americas, 9. p. 100258. DOI https://doi.org/10.1016/j.lana.2022.100258
Carrillo-Larco, Rodrigo M and Stern, Dalia and Hambleton, Ian R and Lotufo, Paulo and Di Cesare, Mariachiara and Hennis, Anselm and Ferreccio, Catterina and Irazola, Vilma and Perel, Pablo and Gregg, Edward W and Miranda, J Jaime and Ezzati, Majid and Danaei, Goodarz (2022) Derivation, internal validation, and recalibration of a cardiovascular risk score for Latin America and the Caribbean (Globorisk-LAC): A pooled analysis of cohort studies. The Lancet Regional Health - Americas, 9. p. 100258. DOI https://doi.org/10.1016/j.lana.2022.100258
Abstract
Background Risk stratification is a cornerstone of cardiovascular disease (CVD) prevention and a main strategy proposed to achieve global goals of reducing premature CVD deaths. There are no cardiovascular risk scores based on data from Latin America and the Caribbean (LAC) and it is unknown how well risk scores based on European and North American cohorts represent true risk among LAC populations. Methods We developed a CVD (including coronary heart disease and stroke) risk score for fatal/non-fatal events using pooled data from 9 prospective cohorts with 21,378 participants and 1,202 events. We developed laboratory-based (systolic blood pressure, total cholesterol, diabetes, and smoking), and office-based (body mass index replaced total cholesterol and diabetes) models. We used Cox proportional hazards and held back a subset of participants to internally validate our models by estimating Harrell's C-statistic and calibration slopes. Findings The C-statistic for the laboratory-based model was 72% (70–74%), the calibration slope was 0.994 (0.934–1.055) among men and 0.852 (0.761–0.942) among women; for the office-based model the C-statistic was 71% (69–72%) and the calibration slope was 1.028 (0.980–1.076) among men and 0.811 (0.663–0.958) among women. In the pooled sample, using a 20% risk threshold, the laboratory-based model had sensitivity of 21.9% and specificity of 94.2%. Lowering the threshold to 10% increased sensitivity to 52.3% and reduced specificity to 78.7%. Interpretation The cardiovascular risk score herein developed had adequate discrimination and calibration. The Globorisk-LAC would be more appropriate for LAC than the current global or regional risk scores. This work provides a tool to strengthen risk-based cardiovascular prevention in LAC.
Item Type: | Article |
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Uncontrolled Keywords: | Risk prediction; Primary prevention; Global health; Cardiovascular diseases; Latin America and the Caribbean |
Divisions: | Faculty of Science and Health Faculty of Science and Health > Health and Social Care, School of |
SWORD Depositor: | Unnamed user with email elements@essex.ac.uk |
Depositing User: | Unnamed user with email elements@essex.ac.uk |
Date Deposited: | 10 Aug 2022 08:36 |
Last Modified: | 30 Oct 2024 21:09 |
URI: | http://repository.essex.ac.uk/id/eprint/32983 |
Available files
Filename: PIIS2667193X22000758.pdf
Licence: Creative Commons: Attribution 3.0