TABLE 1.
Characteristics of currently common cardiovascular risk assessment tools in Western countries
| Risk assessment tools | Framingham CVD 4 | Systematic COronary Risk Evaluation (SCORE) 5 | Pooled cohort equations (PCE) 6 | QRISK3 17 |
|---|---|---|---|---|
| Derivation cohort(s) | Framingham original cohort and Framingham offspring cohort | 12 European cohorts in 11 countries | ARIC, CARDIA, CHS, Framingham cohorts | QRESEARCH database |
| Sample size | 8491 participants (4522 women) | 205 178 participants (88 080 women) | 24 626 participants (11 381 women) | 10.56 million participants (5.38 million women) |
| Age range | 30–74 | 40–65 | 40–79 | 25–84 |
| Follow‐up (years) | 12 | 2.7 million person years | At least 12 | 4.4 (median) |
| Risk factors | Age; sex; smoking; BP; total‐C; HDL‐C; hypertensive treatment status; diabetes | Age; sex; smoking; SBP; total‐C or total‐C: HDL‐C ratio (low‐risk countries and high‐risk countries versions) | Age; sex; race (white/African American); smoking; SBP; total‐C; HDL‐C; hypertensive treatment status; diabetes | Age; sex; ethnicity; smoking; SBP; total‐C: HDL‐C ratio; BMI; family history; hypertensive treatment status; diabetes; CKD; AF; RA; Townsend deprivation score; a measure of SBP variability; migraine; corticosteroids; SLE; atypical antipsychotics; severe mental illness; erectile dysfunction |
| End points | 10‐year CVD events (CHD, stroke, PAD, or HF) | 10‐year fatal CVD events | 10‐year hard ASCVD events (non‐fatal MI or CHD death or fatal or non‐fatal stroke) | 10‐year CVD events (CHD, ischemic stroke, or TIA) |
| Tool characteristics | Risk score sheets (tables) | Risk charts | Risk calculators | Risk calculators |
| Statistical analysis |
c‐statistics: 0.763 in men; 0.793 in women χ2 statistics: 13.48 in men; 7.79 in women |
ROC area: 0.70–0.84 in different European cohorts |
c‐statistics: 0.713–0.818 χ2 statistics: 4.86–7.25 |
R2: 59.6% in women; 54.8% in men D statistic: 2.48 in women; 2.26 in men Harrell's C statistic: 0.88 in women; 0.86 in men |
Abbreviations: AF, atrial fibrillation; ARIC, Atherosclerosis Risk in Communities study; ASCVD, arteriosclerotic cardiovascular disease; BMI, body mass index; CARDIA, Coronary Artery Risk Development in Young Adults study; CHD, coronary heart disease; CHS, Cardiovascular Health Study; CKD, chronic kidney disease; CVD, cardiovascular disease; HDL‐C, high‐density lipoprotein cholesterol; HF, heart failure; MI, myocardial infraction; PAD, peripheral artery disease; RA, rheumatoid arthritis; ROC, receiver operating characteristics curve; SBP, systolic blood pressure; SLE, systemic lupus erythematosus; TIA, transient ischemic attack; total‐C, total cholesterol.