Zhang Xiao-Fei, Attia John, D'Este Catherine, Yu Xue-Hai, Wu Xi-Gui
Department of Epidemiology, Cardiovascular Institute and Fu Wai Hospital, Peking Union Medical College, People's Republic of China.
J Clin Epidemiol. 2005 Sep;58(9):951-8. doi: 10.1016/j.jclinepi.2005.01.013.
This article aims to address two issues: first, whether risk scores derived from Caucasian cohorts can accurately predict coronary heart disease (CHD) in a Chinese population; second, derivation and validation of a new risk prediction score for cardiovascular disease (CVD) from a Chinese cohort.
A cohort of 4,400 male steelworkers (18-74 years old) recruited between 1974-1980 was followed up for an average 13.5 years. A Cox model was used to predict 10 year risk of CHD, ischemic, and hemorrhagic stroke based on blood pressure, age, total cholesterol, body mass index, and smoking status.
The prediction rule from the European Recommendations greatly overestimates the risk of CHD in Orientals. The new models had good predictive ability, with the area under receiver operating characteristic curves (AUCs area) in the derivation set being 0.76, 0.72, and 0.82 for CHD, ischemic, and hemorrhagic stroke separately; AUCs in the validation set were equally good, at 0.76, 0.78, and 0.82, respectively.
The risk stratification rules derived from Caucasian cohorts overestimates the CHD risk in Orientals, and we derive a specific risk stratification rule for CHD, ischemic and hemorrhagic stroke for Chinese men.
本文旨在解决两个问题：第一，源自白种人队列的风险评分能否准确预测中国人群的冠心病（CHD）；第二，从中国队列中推导并验证一种新的心血管疾病（CVD）风险预测评分。
对1974年至1980年间招募的4400名年龄在18 - 74岁之间的男性钢铁工人队列进行了平均13.5年的随访。使用Cox模型根据血压、年龄、总胆固醇、体重指数和吸烟状况预测冠心病、缺血性和出血性中风的10年风险。
欧洲建议中的预测规则大大高估了东方人患冠心病的风险。新模型具有良好的预测能力，在推导集中，冠心病、缺血性和出血性中风的受试者工作特征曲线下面积（AUCs面积）分别为0.76、0.72和0.82；验证集中的AUCs同样良好，分别为0.76、0.78和0.82。
源自白种人队列的风险分层规则高估了东方人患冠心病的风险，我们为中国男性推导了针对冠心病、缺血性和出血性中风的特定风险分层规则。
