Development and validation of a five-year cardiovascular risk assessment tool for Asian adults aged 75 years and older
Abstract Background To identify cardiovascular (CV) risk factors in Asian elderly aged 75 years and older and subsequently develop and validate a sex-specific five-year CV risk assessment tool for this population. Methods This study included 12,174 patients aged ≥ 75 years without a prior history of...
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BMC
2025-01-01
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| Series: | BMC Geriatrics |
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| Online Access: | https://doi.org/10.1186/s12877-024-05660-4 |
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| author | Meng-Chen Hsu Yu-Hua Fu Chi-Chuan Wang Chau-Chung Wu Fang-Ju Lin |
| author_facet | Meng-Chen Hsu Yu-Hua Fu Chi-Chuan Wang Chau-Chung Wu Fang-Ju Lin |
| author_sort | Meng-Chen Hsu |
| collection | DOAJ |
| description | Abstract Background To identify cardiovascular (CV) risk factors in Asian elderly aged 75 years and older and subsequently develop and validate a sex-specific five-year CV risk assessment tool for this population. Methods This study included 12,174 patients aged ≥ 75 years without a prior history of cardiovascular disease at a single hospital in Taiwan. Electronic health records were linked to the National Health Insurance Research Database and the National Death Registry to ensure comprehensive health information. Eligible patients were randomly divided into derivation (80%) and validation (20%) cohorts. A sex-specific CV risk assessment tool was developed to predict major adverse cardiovascular events (MACE) using Cox regression modeling. Results During a median follow-up period of 8.6 years for men and 8.5 years for women in the derivation cohort, MACE occurred in 3.62% of men and 3.02% of women. Predictors for men comprised advanced age, smoking, non-HDL-C levels > 160 mg/dL, metastatic cancer, and aspirin usage. Predictors for women included advanced age, smoking, atrial fibrillation, cancer, dementia, osteoarthritis, systemic lupus erythematosus, use of antihypertensives, and use of oral anticoagulants. In the validation cohort, the sex-specific risk assessment tool demonstrated fair discriminative power (AUC: men, 0.64; women, 0.68). Model calibration demonstrated good performance for women but was less optimal for men. Conclusions This sex-specific CV risk assessment tool shows fair discriminative capability in estimating risk of cardiovascular disease among elderly Asians, potentially enabling targeted interventions in this vulnerable population. |
| format | Article |
| id | doaj-art-a5c9dcc7aa2049278c626e5884ed0e21 |
| institution | Kabale University |
| issn | 1471-2318 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | BMC Geriatrics |
| spelling | doaj-art-a5c9dcc7aa2049278c626e5884ed0e212025-01-12T12:38:41ZengBMCBMC Geriatrics1471-23182025-01-0125111210.1186/s12877-024-05660-4Development and validation of a five-year cardiovascular risk assessment tool for Asian adults aged 75 years and olderMeng-Chen Hsu0Yu-Hua Fu1Chi-Chuan Wang2Chau-Chung Wu3Fang-Ju Lin4Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan UniversityGraduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan UniversityGraduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan UniversityDivision of Cardiology, Department of Internal Medicine, National Taiwan University HospitalGraduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan UniversityAbstract Background To identify cardiovascular (CV) risk factors in Asian elderly aged 75 years and older and subsequently develop and validate a sex-specific five-year CV risk assessment tool for this population. Methods This study included 12,174 patients aged ≥ 75 years without a prior history of cardiovascular disease at a single hospital in Taiwan. Electronic health records were linked to the National Health Insurance Research Database and the National Death Registry to ensure comprehensive health information. Eligible patients were randomly divided into derivation (80%) and validation (20%) cohorts. A sex-specific CV risk assessment tool was developed to predict major adverse cardiovascular events (MACE) using Cox regression modeling. Results During a median follow-up period of 8.6 years for men and 8.5 years for women in the derivation cohort, MACE occurred in 3.62% of men and 3.02% of women. Predictors for men comprised advanced age, smoking, non-HDL-C levels > 160 mg/dL, metastatic cancer, and aspirin usage. Predictors for women included advanced age, smoking, atrial fibrillation, cancer, dementia, osteoarthritis, systemic lupus erythematosus, use of antihypertensives, and use of oral anticoagulants. In the validation cohort, the sex-specific risk assessment tool demonstrated fair discriminative power (AUC: men, 0.64; women, 0.68). Model calibration demonstrated good performance for women but was less optimal for men. Conclusions This sex-specific CV risk assessment tool shows fair discriminative capability in estimating risk of cardiovascular disease among elderly Asians, potentially enabling targeted interventions in this vulnerable population.https://doi.org/10.1186/s12877-024-05660-4Cardiovascular riskPrimary preventionRisk assessmentElderlyAsian |
| spellingShingle | Meng-Chen Hsu Yu-Hua Fu Chi-Chuan Wang Chau-Chung Wu Fang-Ju Lin Development and validation of a five-year cardiovascular risk assessment tool for Asian adults aged 75 years and older BMC Geriatrics Cardiovascular risk Primary prevention Risk assessment Elderly Asian |
| title | Development and validation of a five-year cardiovascular risk assessment tool for Asian adults aged 75 years and older |
| title_full | Development and validation of a five-year cardiovascular risk assessment tool for Asian adults aged 75 years and older |
| title_fullStr | Development and validation of a five-year cardiovascular risk assessment tool for Asian adults aged 75 years and older |
| title_full_unstemmed | Development and validation of a five-year cardiovascular risk assessment tool for Asian adults aged 75 years and older |
| title_short | Development and validation of a five-year cardiovascular risk assessment tool for Asian adults aged 75 years and older |
| title_sort | development and validation of a five year cardiovascular risk assessment tool for asian adults aged 75 years and older |
| topic | Cardiovascular risk Primary prevention Risk assessment Elderly Asian |
| url | https://doi.org/10.1186/s12877-024-05660-4 |
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