AHA PREVENT Equations and Cardiovascular Disease Risk in Diverse Health Care Populations
Authors' conclusion
The PREVENT model moderately discriminated ASCVD incidence across 4 geographically distinct academic health care systems in the United States. However, calibration metrics varied widely across health care systems, sociodemographics, and underlying cardiometabolic comorbidities.
Study context
- Population
- Patients aged 30 to 79 years without prior atherosclerotic cardiovascular disease (ASCVD), US integrated health care systems, 2010 to 2014
- Participants
- 270,320 patients4 health care systems
- Exposure
- PREVENT predicted vs observed 10-year ASCVD across 4 US health care systems
- MGBn = 136,654
- Mount Sinain = 43,321
- Pennn = 56,889
- Vanderbiltn = 33,456
- Outcome
- Calibration (discordance) and discrimination (C-index) of PREVENT for incident ASCVD
- Follow-up
- 10 years
Methodological detailsmulticentre, external validation
- Multicentre
- External validation
Main finding
As reported in the abstract
| Group | Value | Discordance | C-index |
|---|---|---|---|
| MGB | mean estimated 10-year ASCVD risk 4.9% (SD 4.7%) | −71.0% | 0.70 [95% CI: 0.70-0.70] |
| Mount Sinai | mean estimated 10-year ASCVD risk 6.0% (SD 5.6%) | −36.2% | 0.74 [95% CI: 0.73-0.75] |
| Penn | mean estimated 10-year ASCVD risk 6.0% (SD 5.2%) | +1.3% | 0.69 [95% CI: 0.68-0.70] |
| Vanderbilt | mean estimated 10-year ASCVD risk 4.8% (SD 1.3%) | −40.0% | 0.73 [95% CI: 0.72-0.74] |
Value
MGBmean estimated 10-year ASCVD risk 4.9% (SD 4.7%)
Mount Sinaimean estimated 10-year ASCVD risk 6.0% (SD 5.6%)
Pennmean estimated 10-year ASCVD risk 6.0% (SD 5.2%)
Vanderbiltmean estimated 10-year ASCVD risk 4.8% (SD 1.3%)
Discordance
MGB−71.0%
Mount Sinai−36.2%
Penn+1.3%
Vanderbilt−40.0%
C-index
MGB0.70 [95% CI: 0.70-0.70]
Mount Sinai0.74 [95% CI: 0.73-0.75]
Penn0.69 [95% CI: 0.68-0.70]
Vanderbilt0.73 [95% CI: 0.72-0.74]
Observational data: associations, not effects.
Further findings
Calibration by sex (subgroup)
- Greater underestimation among women, MGB (discordance)
- −80.7%
- Greater underestimation among women, Vanderbilt (discordance)
- −55.5%
- Greater underestimation among men, Mount Sinai (discordance)
- −40.7%
Calibration by race and ethnicity (subgroup)
- Predictive performance varied across health care systems
Overall calibration, PREVENT vs pooled cohort equations (discordance)
- Penn: PREVENT better (PREVENT vs PCE)
- +2.5% vs +93.6%
- MGB: PREVENT worse (PREVENT vs PCE)
- −70.0% vs −41.6%
- Mount Sinai: PREVENT worse (PREVENT vs PCE)
- −36.4% vs 4.8%
- Comparable discrimination
Discrimination by DM or antihypertensive use (subgroup)
- Better discrimination among patients without DM or antihypertensives
Original publication
AHA PREVENT Equations and Cardiovascular Disease Risk in Diverse Health Care Populations. J Am Coll Cardiol. Published 22 July 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →