Latifa Baynouna AlKetbi, Nico Nagelkerke, Noura AlAlawi, Ahmed Humaid, Rudina AlKetbi, Hamda Aleissaee, Noura AlShamsi, Hanan Abdulbaqi, Toqa Fahmawee, Basil AlHashaikeh, Muna AlDobaee, Mariam AlShamsi, Nayla AlAhbabi, AlYazia AlAzeezi, Fatima Shuaib, Jawaher Alnuaimi, Esraa Mahmoud, Alreem AlDhaheri, Mohammed AlMansoori, Sanaa AlKalbani, Aysha AYahyaee, Wesayef AlDerie, Ekram Saeed, Nouf AlMarzooqi, Ahmed AlHassani, Amira AlAhmadi, Mohammad Sahyouni, Farah AlFahmawi, Ali AlAlawi, Yusra Sahalu, Zinab AlAnsari, Khadija Doucoure, Rawan Ashoor, Reem AlShamsi, Maha AlAzeezi, Fatima AlMeqbaali, Noor Yahya, Shamma AlAlawi, Fatima AlKetbi
{"title":"Disease Risk Score Derivation and Validation in Abu Dhabi, United Arab Emirates: A Retrospective Cohort Study.","authors":"Latifa Baynouna AlKetbi, Nico Nagelkerke, Noura AlAlawi, Ahmed Humaid, Rudina AlKetbi, Hamda Aleissaee, Noura AlShamsi, Hanan Abdulbaqi, Toqa Fahmawee, Basil AlHashaikeh, Muna AlDobaee, Mariam AlShamsi, Nayla AlAhbabi, AlYazia AlAzeezi, Fatima Shuaib, Jawaher Alnuaimi, Esraa Mahmoud, Alreem AlDhaheri, Mohammed AlMansoori, Sanaa AlKalbani, Aysha AYahyaee, Wesayef AlDerie, Ekram Saeed, Nouf AlMarzooqi, Ahmed AlHassani, Amira AlAhmadi, Mohammad Sahyouni, Farah AlFahmawi, Ali AlAlawi, Yusra Sahalu, Zinab AlAnsari, Khadija Doucoure, Rawan Ashoor, Reem AlShamsi, Maha AlAzeezi, Fatima AlMeqbaali, Noor Yahya, Shamma AlAlawi, Fatima AlKetbi","doi":"10.1161/JAHA.124.035930","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease risk assessment is a key tool in primary prevention. The ADRS (Abu Dhabi Risk Study) is a retrospective cohort study aiming to develop 10-year risk prediction equations for coronary artery disease (CAD), stroke, and atherosclerotic cardiovascular disease (ASCVD), and validate international risk equations.</p><p><strong>Methods and results: </strong>The 8699 participants were examined in the Abu Dhabi cardiovascular screening program from 2011 to 2013 with a subsequent average follow-up of 9.2 years. They were assessed in 2023 for new CAD, admissions for acute coronary syndrome, or stroke. The validation cohort, 2554 subjects, is from the 2016 to 2017 Abu Dhabi community screening program, with 6.67 years average follow-up. Of 8504 ASCVD-free subjects, 250 experienced new CAD events. ASCVD risk factors in this population were age, sex, smoking, high cholesterol/high-density lipoprotein ratio, and diabetes diagnosis, in addition to low vitamin D level and low glomerular filtration rate. Three ADRS prediction models were derived using Cox regression. The ADRS-CAD had a C statistic of 0.899 (0.882-0.916) compared with 0.828 (0.803-0.852) for the Framingham Risk Score in the same sample. ADRS-stroke had a C statistic of 0.904 (0.865-0.944). The ADRS-ASCVD had a C statistic of 0.898 (0.883-0.913) compared with 0.891 (0.875-0.907) of pooled cohort equations and 0.825 (0.802-0.847) for Framingham Risk Score-cardiovascular disease. Applying our formulas to the validation cohort yielded C statistics of 0.825 (0.803-0.846), 0.799 (0.774-0.824), and 0.761 (0.71-0.813) for ASCVD, CAD, and stroke, respectively. The pooled cohort equations in this cohort had a C statistic for ASCVD of 0.824 (0.802-0.846).</p><p><strong>Conclusions: </strong>This study demonstrates the value of tailoring risk assessments to local populations and health care contexts.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e035930"},"PeriodicalIF":5.0000,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the American Heart Association","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1161/JAHA.124.035930","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Cardiovascular disease risk assessment is a key tool in primary prevention. The ADRS (Abu Dhabi Risk Study) is a retrospective cohort study aiming to develop 10-year risk prediction equations for coronary artery disease (CAD), stroke, and atherosclerotic cardiovascular disease (ASCVD), and validate international risk equations.
Methods and results: The 8699 participants were examined in the Abu Dhabi cardiovascular screening program from 2011 to 2013 with a subsequent average follow-up of 9.2 years. They were assessed in 2023 for new CAD, admissions for acute coronary syndrome, or stroke. The validation cohort, 2554 subjects, is from the 2016 to 2017 Abu Dhabi community screening program, with 6.67 years average follow-up. Of 8504 ASCVD-free subjects, 250 experienced new CAD events. ASCVD risk factors in this population were age, sex, smoking, high cholesterol/high-density lipoprotein ratio, and diabetes diagnosis, in addition to low vitamin D level and low glomerular filtration rate. Three ADRS prediction models were derived using Cox regression. The ADRS-CAD had a C statistic of 0.899 (0.882-0.916) compared with 0.828 (0.803-0.852) for the Framingham Risk Score in the same sample. ADRS-stroke had a C statistic of 0.904 (0.865-0.944). The ADRS-ASCVD had a C statistic of 0.898 (0.883-0.913) compared with 0.891 (0.875-0.907) of pooled cohort equations and 0.825 (0.802-0.847) for Framingham Risk Score-cardiovascular disease. Applying our formulas to the validation cohort yielded C statistics of 0.825 (0.803-0.846), 0.799 (0.774-0.824), and 0.761 (0.71-0.813) for ASCVD, CAD, and stroke, respectively. The pooled cohort equations in this cohort had a C statistic for ASCVD of 0.824 (0.802-0.846).
Conclusions: This study demonstrates the value of tailoring risk assessments to local populations and health care contexts.
期刊介绍：
As an Open Access journal, JAHA - Journal of the American Heart Association is rapidly and freely available, accelerating the translation of strong science into effective practice.
JAHA is an authoritative, peer-reviewed Open Access journal focusing on cardiovascular and cerebrovascular disease. JAHA provides a global forum for basic and clinical research and timely reviews on cardiovascular disease and stroke. As an Open Access journal, its content is free on publication to read, download, and share, accelerating the translation of strong science into effective practice.
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