Value Of Chinese Evaluation Method Versus Pooled Cohort Equations For Assessing The 10-year Risk Of Ischemic Cardiovascular Disease In Population Undergoing Health Examination

ObjectiveTo determine which one of the two methods,Chinese evaluation method for10-year risk of ischemic cardiovascular disease(CVD)(hereinafter referred to as "Chinese evaluation method")proposed in 2011 Chinese guidelines for prevention of cardiovascular disease and pooled cohort equations for atherosclerotic cardiovascular diseases(ASCVD)recommended by American College of Cardiology/ American Heart Association(ACC/AHA)in 2013(hereinafter referred to as "Pooled cohort equations"),can evaluate CVD risk more accurately for population having health examination.MethodsTotally 733 individuals(40~79 years old,no history of CVD)having health examination in Physical Examination Center of Beijing Chaoyang Hospital Affiliated to Capital Medical University from April to September 2016 were enrolled.Chinese evaluation method and pooled cohort equations were used to assess their 10-year absolute risk of CVD,respectively.We chose the carotid atherosclerotic plaques as an alternative indicator of CVD.Predicting the 10-year absolute risk of carotid atherosclerotic plaques was supposed to indirectly reflect the values of the two assessment methods of CVD risk.ResultsPooled cohort equations had higher accuracy than Chinese evaluation methodin predicting the absolute risk of CVD [3.6%(6.6%)vs.1.5%(3.4%),Z=-19.122,P<0.05].10-year absolute CVD risk of participants predicted by the two methods distributed differently.Taking 7.5% as the value for low risk threshold of 10-year absolute risk of CVD,participants with 10-year absolute risk of CVD< 7.5% and?7.5% could be assigned to low risk group and non-low risk group,respectively.The detection rates of low risk participants of pooled cohort equations and Chinese evaluation method were respectively 73.1%(536/733)and 94.1%(690/733).The detection rates of non-low risk participants of pooled cohort equations was higher than that of Chinese evaluation method [26.9%(197/733)vs.5.9%(43/733),?2 =146.306,P<0.05].As for the prediction of the absolute risk of carotid atherosclerotic plaques,pooled cohort equations had higher area under the ROC curve(AUC)value than Chinese evaluation method did {0.770 [95%CI(0.738,0.800)]vs.0.717 [95%CI(0.683,0.749)],Z=3.935,P<0.05}.ConclusionPooled cohort equations assesses 10-year absolute risk of carotid plaques more accurately in population having health examination than Chinese evaluation method,which suggests that it may be more accurate to evaluate the 10-year risk of CVD.Therefore,it is advisable to use pooled cohort equations clinically to identify high-risk groups timely,by which the primary prevention of CVD can be promoted.