Development and Validation of a Risk Prediction Model for Atherosclerotic Cardiovascular Disease in Japanese Adults: The Hisayama Study

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  • Honda Takanori
    Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University
  • Chen Sanmei
    Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University
  • Hata Jun
    Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
  • Yoshida Daigo
    Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University
  • Hirakawa Yoichiro
    Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
  • Furuta Yoshihiko
    Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University Department of Medical-Engineering Collaboration for Healthy Longevity, Graduate School of Medical Sciences, Kyushu University
  • Shibata Mao
    Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University
  • Sakata Satoko
    Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
  • Kitazono Takanari
    Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
  • Ninomiya Toshiharu
    Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University

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<p>Aim:To develop and validate a new risk prediction model for predicting the 10-year risk of atherosclerotic cardiovascular disease (ASCVD) in Japanese adults. </p><p>Methods: A total of 2,454 participants aged 40–84 years without a history of cardiovascular disease (CVD) were prospectively followed up for 24 years. An incident ASCVD event was defined as the first occurrence of coronary heart disease or atherothrombotic brain infarction. A Cox proportional hazards regression model was used to construct the prediction model. In addition, a simplified scoring system was translated from the developed prediction model. The model performance was evaluated using Harrell’s C statistics, a calibration plot with the Greenwood-Nam-D’Agostino test, and a bootstrap validation procedure. </p><p>Results: During a median of a 24-year follow-up, 270 participants experienced the first ASCVD event. The predictors of the ASCVD events in the multivariable Cox model included age, sex, systolic blood pressure, diabetes, serum high-density lipoprotein cholesterol, serum low-density lipoprotein cholesterol, proteinuria, smoking habits, and regular exercise. The developed models exhibited good discrimination with negligible evidence of overfitting (Harrell’s C statistics: 0.786 for the multivariable model and 0.789 for the simplified score) and good calibrations (the Greenwood-Nam-D’Agostino test: P=0.29 for the multivariable model, 0.52 for the simplified score). </p><p>Conclusion: We constructed a risk prediction model for the development of ASCVD in Japanese adults. This prediction model exhibits great potential as a tool for predicting the risk of ASCVD in clinical practice by enabling the identification of specific risk factors for ASCVD in individual patients. </p>

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