Equations for Predicting the 10-Year Risk of Atherosclerotic Cardiovascular Disease in Population With Obesity

Zhou, Y; Liu, M; Chen, Z; Cai, X; He, L; Lei, J; Huang, R; Zhang, S; Huang, Y; Xiong, Z; Wang, P; Xu, X; Xu, X; Lai, Y; Li, M; Lin, Y; Xie, P; Zhuang, X; Guo, Y; Liao, X

doi:10.1016/j.jacadv.2024.101542

Equations for Predicting the 10-Year Risk of Atherosclerotic Cardiovascular Disease in Population With Obesity

JACC AdvPublished 15 Jan 2025development and validation of gender-specific equations to predict atherosclerotic cardiovascular disease (ASCVD)

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Authors' conclusion

Our equations provided better prediction of 10-year ASCVD risk in individuals with obesity in the MESA cohort, outperforming both PCEs and FRS.

Study context

Population: Participants with obesity (body mass index ≥30 kg/m²) in the ARIC and MESA studiesderivation and validation cohorts · ARIC (derivation) 3,058 · MESA (validation) 1,953

Predictors: ASCVD Risk estimation with Obesity-Specific Equations (AROSE), compared with the 2008 Framingham risk score (FRS) and pooled cohort equations (PCEs)
Predicted outcome: ASCVD

Methodological detailsderivation cohort (ARIC) and validation cohort (MESA)

Derivation cohort (ARIC) and validation cohort (MESA)

Model performance

As reported in the abstract

C-statistic

AROSE, derivation cohort (ARIC), men10-year risk

0.758

AROSE, derivation cohort (ARIC), women10-year risk

0.817

AROSEmen · validation cohort (MESA)

0.707

AROSEwomen · validation cohort (MESA)

0.734

PCEsmen · validation cohort (MESA)

0.706

PCEswomen · validation cohort (MESA)

0.705

FRSmen · validation cohort (MESA)

0.693

FRSwomen · validation cohort (MESA)

0.703

Test or model	Calibration chi-square	Calibration χ2
AROSE, derivation cohort (ARIC), men	1.71, P = 0.634	— not stated in the abstract
AROSE, derivation cohort (ARIC), women	— not stated in the abstract	0.77, P = 0.857

Calibration chi-square

AROSE, derivation cohort (ARIC), men1.71, P = 0.634

AROSE, derivation cohort (ARIC), women—

Calibration χ2

AROSE, derivation cohort (ARIC), men—

AROSE, derivation cohort (ARIC), women0.77, P = 0.857

— not stated in the abstract

Further findings

ASCVD, validation cohort (MESA)

AROSE outperformed both PCEs and FRS

Net reclassification improvement and decision curve analysis, AROSE vs PCEs and FRS

Significant net reclassification improvements: P < 0.05
Higher net clinical benefit in decision curve analysis

Original publication

Equations for Predicting the 10-Year Risk of Atherosclerotic Cardiovascular Disease in Population With Obesity. JACC Adv. Published 15 January 2025. doi:10.1016/j.jacadv.2024.101542

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