1. Development and validation of an ankle brachial index risk model for the prediction of cardiovascular events
- Author
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Fowkes, FGR, Murray, GD, Butcher, I, Folsom, AR, Hirsch, AT, Couper, DJ, DeBacker, G, Kornitzer, M, Newman, Sutton-Tyrrell, KC, Cushman, M, Lee, AJ, Price, JF, D'Agostino, RB, Murabito, JM, Norman, PE, Masaki, KH, Bouter, LM, Heine, RJ, Stehouwer, CDA, McDermott, MM, Stoffers, HEJH, Knottnerus, JA, Ogren, M, Hedblad, B, Koenig, W, Meisinger, C, Cauley, JA, Franco, OH, Hunink, MGM, Hofman, A, Witteman, JC, Criqui, MH, Langer, RD, Hiatt, WR, and Hamman, RF
- Subjects
Cardiovascular ,Prevention ,Clinical Research ,Heart Disease ,Adult ,Aged ,Aged ,80 and over ,Ankle Brachial Index ,Cardiovascular Diseases ,Europe ,Female ,Humans ,Male ,Middle Aged ,Models ,Statistical ,Predictive Value of Tests ,Prognosis ,Reproducibility of Results ,Risk Assessment ,Risk Factors ,Sex Factors ,Time Factors ,United States ,White People ,Young Adult ,Ankle Brachial Index Collaboration ,Ankle brachial index ,cardiovascular diseases ,risk assessment ,Cardiorespiratory Medicine and Haematology ,Clinical Sciences ,Cardiovascular System & Hematology - Abstract
BackgroundThe ankle brachial index (ABI) is related to risk of cardiovascular events independent of the Framingham risk score (FRS). The aim of this study was to develop and evaluate a risk model for cardiovascular events incorporating the ABI and FRS.DesignAn analysis of participant data from 18 cohorts in which 24,375 men and 20,377 women free of coronary heart disease had ABI measured and were followed up for events.MethodsSubjects were divided into a development and internal validation dataset and an external validation dataset. Two models, comprising FRS and FRS + ABI, were fitted for the primary outcome of major coronary events.ResultsIn predicting events in the external validation dataset, C-index for the FRS was 0.672 (95% CI 0.599 to 0.737) in men and 0.578 (95% CI 0.492 to 0.661) in women. The FRS + ABI led to a small increase in C-index in men to 0.685 (95% CI 0.612 to 0.749) and large increase in women to 0.690 (95% CI 0.605 to 0.764) with net reclassification improvement (NRI) of 4.3% (95% CI 0.0 to 7.6%, p = 0.050) and 9.6% (95% CI 6.1 to 16.4%, p
- Published
- 2014