TABLE 2.
Characteristics of currently common cardiovascular risk assessment tools in Asian region
| Country/region | Risk assessment tools | Original/established | Derivation cohort(s) | Age range | Risk factors |
|---|---|---|---|---|---|
| China 9 | China‐PAR | Original | InterASIA and China MUCA (1998) | N/A | Age; sex; smoking; SBP; total‐C; HDL‐C; hypertensive treatment status; diabetes; WC; geographic region; urbanization (only for men); family history of ASCVD (only for men) |
| Japan 8 | JALS score | Original | JALS cohorts | 40–89 | Age; sex; smoking; BP; non‐HDL‐C; HDL‐C; hypertensive treatment status; diabetes; BMI; eGFR; AF (AF model and non‐AF model) |
| Malaysia 26 | Framingham CVD 4 | Established | Framingham original cohort and Framingham offspring cohort | 30–74 | Age; sex; smoking; SBP; total‐C; HDL‐C; hypertensive treatment status; diabetes |
| Indonesia 10 | WHO/ISH chart | Established | N/A | ≥40 | Age; sex; smoking; SBP; total‐C; diabetes |
| Vietnam 27 | Framingham CVD 4 | Established | Framingham original cohort and Framingham offspring cohort | 30–74 | Age; sex; smoking; SBP; total‐C; HDL‐C; hypertensive treatment status; diabetes |
| Taiwan 28 , 29 | A point‐based prediction model | Original | CCCC original cohort | ≥35 |
Clinical model: Age; sex; BMI; SBP; smoking Total‐C‐based model: Age; sex; BMI; SBP; total‐C; HDL‐C LDL‐C‐based model: Age; sex; BMI; SBP; LDL‐C; HDL‐C |
| Framingham CHD 18 | Established | Framingham original cohort/TwSHHH | 35–70 | Age; sex; smoking; SBP; total‐C; HDL‐C; diabetes | |
| Singapore 30 | Framingham ATPIII 31 | Established | Framingham cohort | 20–79 | Age; sex; smoking; SBP; total‐C; HDL‐C; hypertensive treatment status |
| Country/region | End points | Statistic characteristics | External validation | Recommended by native guideline (yes/no) | Comments/developments |
|---|---|---|---|---|---|
| China 9 | 10‐year ASCVD events (non‐fatal acute MI or CHD death or fatal or non‐fatal stroke) |
c‐statistics: 0.794 in men; 0.811 in women χ2 statistics: 13.1 in men; 12.8 in women |
Yes | No | |
| Japan 8 | 5‐/10‐year stroke/acute MI/composite outcome of stroke and acute MI/all cardiovascular death events |
ROC area: (model of all cardiovascular death prediction) 0.828 in non‐AF model 0.832 in AF model |
No | Yes | |
| Malaysia 26 | 10‐year CVD events (CHD, stroke, PAD, or HF) |
ROC area: 0.63 χ2 statistics: 3.25 |
Yes | No | CKD is advised in risk prediction for medium‐risk patients. 32 |
| Indonesia 10 | 10‐year fatal or non‐fatal major cardiovascular events (myocardial infarction or stroke) | N/A | N/A | No | |
| Vietnam 27 | 10‐year CVD events (CHD, stroke, PAD, or HF) | N/A | Yes | N/A | Modification and calibration of an existing score for the Vietnamese population. |
| Taiwan 28 , 29 | 10‐year incident CHD events (fatal and nonfatal MI and cases undertaking PCI or CABG) |
ROC area: 0.73–0.78; IDI: 0.2%, p = .11 NRI: 8.2%, p = .11 |
Yes | No | Models as well as point systems were developed. |
| 10‐year CHD events | χ2 statistics: 5.668 in men; 389.086 in women | Yes | Yes | The adjustment factors were submitted to the International Society of Lipids and Atherosclerosis. | |
| Singapore 30 | 10‐year hard CHD events (MI and cardiovascular death) | N/A | Yes | Yes | The tool was modified and adjusted for three ethnic groups in Singapore (Chinese, Malay, and Indian). |
Abbreviations: AF, atrial fibrillation; ASCVD, arteriosclerotic cardiovascular disease; ATP III, Third Report of the Adult Treatment Panel; BMI, body mass index; CCCC, Chin‐San Community Cardiovascular Cohort; CHD, coronary heart disease; China MUCA, China Multi‐Center Collaborative Study of Cardiovascular Epidemiology; China‐PAR, Prediction for ASCVD Risk in China; CKD, chronic kidney disease; CVD, cardiovascular disease; HDL‐C, high‐density lipoprotein cholesterol; HF, heart failure; IDI, integrated discrimination improvement; InterASIA, International Collaborative Study of Cardiovascular Disease in Asia; JALS, Japan Arteriosclerosis Longitudinal Study; LDL‐C, low‐density lipoprotein cholesterol; MI, myocardial infraction; NRI, net reclassification improvement; N/A, data unavailable; PAD, peripheral artery disease; ROC, receiver operating characteristics curve; SBP, systolic blood pressure; total‐C, total cholesterol; TwSHHH, Taiwanese Survey on Hypertension, Hyperglycemia, and Hyperlipidemia; WC, waist circumference; WHO/ISH, World Health Organization/International Society of Hypertension.