Prevention & lipidsDiagnostic or prognostic study
Prediction of individualized lifetime benefit from cholesterol lowering, blood pressure lowering, antithrombotic therapy, and smoking cessation in apparently healthy people
- Prediction model development and external validation study
- competing-risk adjusted (Fine and Gray)
Authors' conclusion
The model can accurately estimate individual-level prognosis and treatment-effects in terms of improved 10-year risk, lifetime risk, and life-expectancy free of CVD.
Study context
- Population
- Apparently healthy people
- Participants
- 6,715 / 9,250 / 4,177 / 25,833 / 23,548
- Comparison
- Multi-Ethnic Study of Atherosclerosis vs Atherosclerosis Risk in Communities vs Heinz Nixdorf Recall vs European Prospective Investigation into Cancer and Nutrition-Netherlands vs Norfolk
- Multi-Ethnic Study of Atherosclerosisn = 6,715
- Atherosclerosis Risk in Communitiesn = 9,250
- Heinz Nixdorf Recalln = 4,177
- European Prospective Investigation into Cancer and Nutrition-Netherlandsn = 25,833
- Norfolkn = 23,548
- Outcome
- Individual-level 10-year and lifetime treatment effects (hard CVD events, non-CVD mortality) of cholesterol lowering, BP lowering, antithrombotic therapy and smoking cessation
Performance
As reported in the abstract
Model performance in external validation
c-statistics
0.67-0.76
Further findings
Illustrative therapy benefit, age 45 vs 70 with otherwise identical risk factors
- 10-year absolute risk reduction, age 70 vs 45
- 11.3% vs. 1.0%
- Gain in life-years free of cardiovascular disease (CVD), age 70 vs 45
- 3.4 vs. 4.5 years
Original publication
Prediction of individualized lifetime benefit from cholesterol lowering, blood pressure lowering, antithrombotic therapy, and smoking cessation in apparently healthy people. Eur Heart J. Published 18 May 2019. doi:10.1093/eurheartj/ehz239
Summarised from the published abstract; every number is checked against it