Article

We aimed to develop and validate a simple coronary heart disease (CHD) risk algorithm applicable to asymptomatic men and women in France, and to
compare its accuracy with that of the last published version of the Framingham
risk function for cardiovascular disease. DESIGN:
A pooled analysis of four
French prospective general-population studies.
METHODS: The baseline and
follow-up data from D.E.S.I.R., PRIME, Three City, and SU.VI.MAX studies were
used. The 10-year CHD risk was estimated by the Cox proportional hazards model
with candidate variables including age, gender, body mass index, waist
circumference, family history of coronary heart disease, smoking status, diabetes
status, systolic blood pressure, and total and high-density lipoprotein (HDL)
cholesterol. RESULTS: The study population included 22,256 subjects (61.4% men)
aged (SD) 56.0 years (8.3) without a personal history of CHD at baseline. After a
mean follow-up of 8.0 years (2.3), 788 first CHD events occurred, 726 in men and
62 in women. The final model included age, gender, age x gender interaction,
current smoking status, diabetes status, systolic blood pressure, total and HDL
cholesterol. Using this model, the number of predicted coronary events fitted
that given by the 10-year Kaplan-Meier survival estimates within each decile of
estimated risk (calibration).
This model had fair discrimination: Harrell
C-index, 0.7831 (95% CI: 0.7704-0.7957). For comparison, the recalibrated
Framingham risk function had equivalent performances compared to the French risk
equation. CONCLUSION: Our 10-year French CHD risk equation based on traditional
risk factors performed at least as well as the recalibrated Framingham cardiovascular disease risk function.

Langue : ANGLAIS