Estimating modifiable coronary heart disease risk in multiple regions of the world: the INTERHEART Modifiable Risk Score

被引：177

作者：

McGorrian, Catherine ^{[1
,2
]}

Yusuf, Salim ^{[1
]}

Islam, Shofiqul ^{[1
]}

Jung, Hyejung ^{[1
]}

Rangarajan, Sumathy ^{[1
]}

Avezum, Alvaro ^{[3
]}

Prabhakaran, Dorairaj ^{[4
]}

Almahmeed, Wael ^{[5
]}

Rumboldt, Zvonko ^{[6
]}

Budaj, Andrzej ^{[7
]}

Dans, Antonio L. ^{[8
]}

Gerstein, Hertzel C. ^{[1
]}

Teo, Koon ^{[1
]}

Anand, Sonia S. ^{[1
]}

机构：

[1] McMaster Univ, Populat Hlth Res Inst, David Braley Cardiovasc Stroke Res Inst, Hamilton, ON L8L 2X2, Canada

[2] Univ Coll Dublin, Sch Publ Hlth Pysiotherapy & Populat Sci, Dublin 2, Ireland

[3] Dante Pazzanese Inst Cardiol, Sao Paulo, Brazil

[4] Ctr Chron Dis Control, New Delhi, India

[5] Sheikh Khalifa Med City, Abu Dhabi, U Arab Emirates

[6] Split Univ, Sch Med, Split, Croatia

[7] Grochowski Hosp Warsaw, Postgrad Med Sch, Warsaw, Poland

[8] Univ Philippines, Philippine Gen Hosp, Manila, Philippines

来源：

EUROPEAN HEART JOURNAL | 2011年 / 32卷 / 05期

基金：

加拿大健康研究院;

关键词：

Risk score; Myocardial infarction; Prediction; Ethnic; Global; Risk factors; ACUTE MYOCARDIAL-INFARCTION; CARDIOVASCULAR-DISEASE; 52; COUNTRIES; APOLIPOPROTEIN-B; PRIMARY-CARE; PREVENTION; PREDICTION; REGRESSION; MODELS; ASSOCIATION;

D O I：

10.1093/eurheartj/ehq448

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims Summating risk factor burden is a useful approach in the assessment of cardiovascular risk among apparently healthy individuals. We aimed to derive and validate a new score for myocardial infarction (MI) risk using modifiable risk factors, derived from the INTERHEART case-control study (n = 19 470). Methods and results Multiple logistic regression was used to create the INTERHEART Modifiable Risk Score (IHMRS). Internal validation was performed using split-sample methods. External validation was performed in an international prospective cohort study. A risk model including apolipoproteins, smoking, second-hand smoke exposure, hypertension, and diabetes was developed. Addition of further modifiable risk factors did not improve score discrimination in an external cohort. Split-sample validation studies showed an area under the receiver-operating characteristic (ROC) curve c-statistic of 0.71 [95% confidence interval (CI): 0.70, 0.72]. The IHMRS was positively associated with incident MI in a large cohort of people at low risk for cardiovascular disease [12% increase in MI risk (95% CI: 8, 16%) with a 1-point increase in score] and showed appropriate discrimination in this cohort (ROC c-statistic 0.69, 95% CI: 0.64, 0.74). Results were consistent across ethnic groups and geographic regions. A non-laboratory-based score is also supplied. Conclusions Using multiple modifiable risk factors from the INTERHEART case-control study, we have developed and validated a simple score for MI risk which is applicable to an international population.

引用

页码：581 / U1400

页数：10