Table 3.
Additional predictive power for Hard CVD by the ASCVD risk enhancersa: Tehran lipid and glucose study (1999–2016)
| ACC/AHA model HR (95%) |
p | Enhanced model HR (95%) |
p | ||
|---|---|---|---|---|---|
| Median 10-year follow-up | |||||
| Model componentsb 1 | |||||
| ASCVD-PCE Score | 0.96 (0.83–1.10) | 0.53 | 0.95 (0.82–1.10) | 0.46 | |
| HDP | 5.35 (1.22–23.38) | 0.026 | |||
| Model predictive performance indexes 1 | |||||
| C-indexc (95% CI) | 0.52 (0.42–0.61) | < 0.001 | 0.56 (0.49–0.63) | < 0.001 | |
| IDI (95% CIs) | 0.006 (− 0.03–0.04) | 0.74 | |||
| Model componentsb 2 | |||||
| ASCVD-PCE Score | 0.96 (0.83–1.10) | 0.53 | 0.96 (0.84–1.11) | 0.63 | |
| GDM/Macrosomia | 3.18 (1.05–9.65) | 0.041 | |||
| Model predictive performance indexes 2 | |||||
| C-indexc (95% CI) | 0.52 (0.42–0.61) | < 0.001 | 0.60 (0.48–0.74) | < 0.001 | |
| IDI (95% CIs) | 0.0007 (− 0.03–0.03) | 0.97 | |||
| Model components 3 | |||||
| ASCVD-PCE Score | 1.09 (1.03–1.14) | 0.001 | 1.08 (1.02–1.14) | 0.004 | |
| High blood pressure | 1.53 (0.94–2.48) | 0.08 | |||
| Model predictive performance indexes 3 | |||||
| C-indexc (95% CI) | 0.60 (0.58–0.62) | < 0.001 | 0.62 (0.49–0.74) | < 0.001 | |
| IDI (95% CIs) | 0.001 (− 0.002–0.006) | 0.55 | |||
| Median 15-year follow-up | |||||
| Model components 1 | |||||
| ASCVD-PCE Score | 1.06 (1.03–1.10) | 0.001 | 1.06 (1.025–1.11) | 0.001 | |
| METS | 1.47 (1.05–2.06) | 0.026 | |||
| Model predictive performance indexes 1 | |||||
| C-indexc (95% CI) | 0.58 (0.55–0.62) | < 0.001 | 0.58 (0.51–0.65) | < 0.001 | |
| IDI (95% CIs) | 0.003 (− 0.003–0.01) | 0.36 | |||
| Model components 2 | |||||
| ASCVD-PCE Score | 1.06 (1.03–1.10) | 0.001 | 1.06 (1.02–1.10) | 0.001 | |
| High WC | 1.40 (1.0–1.95) | 0.05 | |||
| Model predictive performance indexes 2 | |||||
| C-indexc (95% CI) | 0.58 (0.55–0.62) | < 0.001 | 0.58 (0.51–0.65) | < 0.001 | |
| IDI (95% CIs) | 0.002 (− 0.003–0.007) | 0.46 | |||
| Model components 3 | |||||
| ASCVD-PCE Score | 1.06 (1.03–1.10) | 0.001 | 1.06 (1.02–1.10) | 0.004 | |
| High blood pressure | 1.52 (1.07–2.15) | 0.02 | |||
| Model predictive performance indexes 3 | |||||
| C-indexc (95% CI) | 0.58 (0.55–0.62) | < 0.001 | 0.58 (0.51–0.65) | < 0.001 | |
| IDI (95% CIs) | 0.002 (− 0.004–00.008) | 0.45 | |||
ACC/AHA American College of Cardiology and the American Heart Association, ASCVD atherosclerotic cardiovascular disease, Mets metabolic syndrome, GDM gestational diabetes, HDP hypertensive disorders pregnancy, CVD cardiovascular disease, AUC area under the curve, IDI integrated discrimination improvement, CI confidence interval, p p-value
aSignificant ASCVD risk factors
bOnly among women
cC-index: Concordance index. The difference between C-indices was not significant
dC-index: indicate the discriminative ability of the model