Prevention & lipidsCohort study
Performance of the ACC/AHA Pooled Cohort Cardiovascular Risk Equations in Clinical Practice
- Retrospective cohort study
- community-based
- validation study
- Median follow-up 16.5 years, truncated at 10 years
Authors' conclusion
The PCE performed well in a community cohort representing real-world clinical practice. Values outside PCE ranges and initiation of statin medication did not affect performance.
Study context
- Population
- Consecutive adults seeking primary care in Olmsted County, Minnesota, 1997–2000, followed through 2016
- Participants
- 30,042 adults
- Outcome
- Pooled cohort equation (PCE) performance (c-statistic; calculated vs observed ASCVD risk) for ASCVD events (nonfatal and fatal MI and ischemic stroke)
- Follow-up
- 10 years
Main finding
As reported in the abstract
PCE discrimination for ASCVD
- Atherosclerotic cardiovascular disease (ASCVD) events
- 1,555 (5.2%)
- Mean ASCVD risk
- 5.6% ± 8.73%
- c-statistic overall
- 0.78
- c-statistic, non-White female (highest)
- 0.81
- c-statistic, White male (lowest)
- 0.77
Observational data: associations, not effects.
Further findings
Out-of-range values and statin initiation
- Out-of-range values and statin initiation did not affect model performance
Original publication
Performance of the ACC/AHA Pooled Cohort Cardiovascular Risk Equations in Clinical Practice. J Am Coll Cardiol. Published 10 October 2023. doi:10.1016/j.jacc.2023.07.018
Summarised from the published abstract; every number is checked against it