Derivation, internal validation, and recalibration of a cardiovascular risk score for Latin America and the Caribbean (Globorisk-LAC): A pooled analysis of cohort studies

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dc.contributor.authorCarrillo-Larco, Rodrigo M.
dc.contributor.authorStern, Dalia
dc.contributor.authorHambleton, Ian R.
dc.contributor.authorLotufo, Paulo
dc.contributor.authorDi Cesare, Mariachiara
dc.contributor.authorHennis, Anselm
dc.contributor.authorFerreccio, Catterina
dc.contributor.authorIrazola, Vilma
dc.contributor.authorPerel, Pablo
dc.contributor.authorGregg, Edward W.
dc.contributor.authorMiranda, J. Jaime
dc.contributor.authorEzzati, Majid
dc.contributor.authorDanaei, Goodarz
dc.date.accessioned2025-01-20T21:00:47Z
dc.date.available2025-01-20T21:00:47Z
dc.date.issued2022
dc.description.abstractBackground Risk stratification is a cornerstone of cardiovascular disease (CVD) prevention and a main strategy proposed to achieve global goals of reducing premature CVD deaths. There are no cardiovascular risk scores based on data from Latin America and the Caribbean (LAC) and it is unknown how well risk scores based on European and North American cohorts represent true risk among LAC populations.
dc.description.abstractMethods We developed a CVD (including coronary heart disease and stroke) risk score for fatal/non-fatal events using pooled data from 9 prospective cohorts with 21,378 participants and 1,202 events. We developed laboratory-based (systolic blood pressure, total cholesterol, diabetes, and smoking), and office-based (body mass index replaced total cholesterol and diabetes) models. We used Cox proportional hazards and held back a subset of participants to internally validate our models by estimating Harrell's C-statistic and calibration slopes.
dc.description.abstractFindings The C-statistic for the laboratory-based model was 72% (70- 74%), the calibration slope was 0.994 ( 0.934-1.055) among men and 0.852 (0.761-0.942) among women; for the office-based model the C-statistic was 71% ( 69-72%) and the calibration slope was 1.028 (0.980-1.076) among men and 0.811 (0.663-0.958) among women. In the pooled sample, using a 20% risk threshold, the laboratory-based model had sensitivity of 21.9% and specificity of 94.2%. Lowering the threshold to 10% increased sensitivity to 52.3% and reduced specificity to 78.7%.
dc.description.abstractInterpretation The cardiovascular risk score herein developed had adequate discrimination and calibration. The Globorisk-LAC would be more appropriate for LAC than the current global or regional risk scores. This work provides a tool to strengthen risk-based cardiovascular prevention in LAC.
dc.description.abstractCopyright (c) 2022 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
dc.description.funderWellcome Trust
dc.fuente.origenWOS
dc.identifier.doi10.1016/j.lana.2022.100258
dc.identifier.issn2667-193X
dc.identifier.urihttps://doi.org/10.1016/j.lana.2022.100258
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/92738
dc.identifier.wosidWOS:000904625400021
dc.language.isoen
dc.revistaLancet regional health-americas
dc.rightsacceso restringido
dc.subjectRisk prediction
dc.subjectPrimary prevention
dc.subjectGlobal health
dc.subjectCardiovascular diseases
dc.subjectLatin America and the Caribbean
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleDerivation, internal validation, and recalibration of a cardiovascular risk score for Latin America and the Caribbean (Globorisk-LAC): A pooled analysis of cohort studies
dc.typeartículo
dc.volumen9
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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