Rospleszcz Susanne, Starnecker Fabian, Linkohr Birgit, von Scheidt Moritz, Gieger Christian, Schunkert Heribert, Peters Annette
Department of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Medical Faculty, Ludwig-Maximilians-Universität München, 80539 Munich, Germany.
Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany.
Diagnostics (Basel). 2022 Apr 12;12(4):965. doi: 10.3390/diagnostics12040965.
The Framingham Risk Score to predict 30-year risk (FRS30y) of cardiovascular disease (CVD) constitutes an important tool for long-term risk prediction. However, due to its complex statistical properties and the paucity of large population-based cohorts with appropriate data, validation of the FRS30y is lacking. A population-based cohort from Southern Germany (N = 3110, 1516 (48.7%) women) was followed up for a median time of 29.5 [18.7, 31.2] years. Discrimination and calibration were assessed for the original, recalibrated and refitted FRS30y version. During follow up, 620 incident CVD events (214 in women) occurred. The FRS30y showed adequate discrimination (original and recalibrated version: Area under the curve (AUC): 78.4 for women and 74.9 for men) but overestimated actual CVD risk (original version: discordance 45.4% for women and 37.3% for men, recalibrated version: 37.6% and 28.6%, respectively). Refitting showed substantial improvement in neither discrimination nor calibration. The performance of FRS30y is adequate for long-term CVD risk prediction and could serve as an important tool in risk communication, especially for younger audiences.
用于预测心血管疾病（CVD）30年风险的弗雷明汉风险评分（FRS30y）是长期风险预测的重要工具。然而，由于其复杂的统计特性以及缺乏具备适当数据的大规模人群队列，FRS30y的验证尚显不足。对来自德国南部的一个人群队列（N = 3110，1516名（48.7%）女性）进行了为期29.5 [18.7, 31.2]年的中位随访。对原始、重新校准和重新拟合的FRS30y版本进行了辨别力和校准评估。随访期间，发生了620例新发CVD事件（女性214例）。FRS30y显示出足够的辨别力（原始版本和重新校准版本：曲线下面积（AUC）：女性为78.4，男性为74.9），但高估了实际的CVD风险（原始版本：女性不一致率为45.4%，男性为37.3%；重新校准版本：分别为37.6%和28.6%）。重新拟合在辨别力和校准方面均未显示出实质性改善。FRS30y的性能足以用于长期CVD风险预测，并且可作为风险沟通中的重要工具，尤其是针对年轻受众。
