Abstract 17048: Dederivation and Validation of a Simple Heart Risk Score in 608,544 Thai Adults: HCUR Study

• Published in: Circulation (New York, N.Y.) N.Y.), 2018-11, Vol.138 (Suppl_1 Suppl 1), p.A17048-A17048
• Main Authors: Chamnan, Parinya, Mahawanakul, Weera, Boongird, Prasert, Nitiyanant, Wannee, Aekplakorn, Wichai
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.138.suppl_1.17048

IntroductionMost heart risk prediction equations were developed in Western populations. These risk scores are likely to perform less well in Asian populations, who have different background risk.HypothesisThis study aimed to develop and validate a new risk algorithm for estimating 5-year risk of developing coronary heart disease (CHD) in a large retrospective cohort of Thai general population.MethodsThis retrospective cohort was derived from the linkage of 2006 health checks data with diagnostic information from electronic health records of 608,544 men and women aged 20 years and above residing in Ubon Ratchathani. It was randomly and evenly divided into the derivation and validation cohorts. An outcome of interest was first recorded diagnosis of CHD over a period of 6 years between January 2006 and December 2012. A Cox proportional hazards model was used to estimate effects of risk factors on CHD risk and to derive a risk equation in the derivation cohort. Measures of discrimination, global model fits and calibration were calculated in the validation cohort.ResultsThe derivation cohort comprised of 304,272 individuals, who contributed 1,757,369 person-years of follow-up and 1,272 incident cases of CHD, while the validation cohort comprised of 304,272 individuals (1,757,312 person-years), with 1,290 incident cases of stroke. The risk equation was 0.0580 x Age (years) + 0.5739 x Sex (Male=1) + 0.3850 x Hypertension (present=1) + 0.7080 x Diabetes (present=1) + 0.0386 x Body mass index (kg/m) + 0.2117 x Central obesity (present=1) - 0.1389 (if exercise 1-2 days/week) or -0.3975 (if exercise 3-5 days/week) or - 0.5598 (if exercise >5 days/week). The stroke risk equation had a reasonably good discriminatory ability in the validation cohort with the area under the receiver operating characteristic curve of 0.790 (95%CI 0.779-0.801). The risk equation had good global model fit as measured by Bayesian information criteria. The Gronnesby and Borgan test showed good calibration, with chi-square statistic of 809.45 (p