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ABSTRACT: Objective
The objectives of this study were to develop a coronary heart disease (CHD) risk model among the Korean Heart Study (KHS) population and compare it with the Framingham CHD risk score.Design
A prospective cohort study within a national insurance system.Setting
18 health promotion centres nationwide between 1996 and 2001 in Korea.Participants
268 315 Koreans between the ages of 30 and 74 years without CHD at baseline.Outcome measure
Non-fatal or fatal CHD events between 1997 and 2011. During an 11.6-year median follow-up, 2596 CHD events (1903 non-fatal and 693 fatal) occurred in the cohort. The optimal CHD model was created by adding high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein (LDL)-cholesterol and triglycerides to the basic CHD model, evaluating using the area under the receiver operating characteristic curve (ROC) and continuous net reclassification index (NRI).Results
The optimal CHD models for men and women included HDL-cholesterol (NRI=0.284) and triglycerides (NRI=0.207) from the basic CHD model, respectively. The discrimination using the CHD model in the Korean cohort was high: the areas under ROC were 0.764 (95% CI 0.752 to 0.774) for men and 0.815 (95% CI 0.795 to 0.835) for women. The Framingham risk function predicted 3-6 times as many CHD events than observed. Recalibration of the Framingham function using the mean values of risk factors and mean CHD incidence rates of the KHS cohort substantially improved the performance of the Framingham functions in the KHS cohort.Conclusions
The present study provides the first evidence that the Framingham risk function overestimates the risk of CHD in the Korean population where CHD incidence is low. The Korean CHD risk model is well-calculated alternations which can be used to predict an individual's risk of CHD and provides a useful guide to identify the groups at high risk for CHD among Koreans.
SUBMITTER: Jee SH
PROVIDER: S-EPMC4039825 | biostudies-literature | 2014 May
REPOSITORIES: biostudies-literature
Jee Sun Ha SH Jang Yangsoo Y Oh Dong Joo DJ Oh Byung-Hee BH Lee Sang Hoon SH Park Seong-Wook SW Seung Ki-Bae KB Mok Yejin Y Jung Keum Ji KJ Kimm Heejin H Yun Young Duk YD Baek Soo Jin SJ Lee Duk Chul DC Choi Sung Hee SH Kim Moon Jong MJ Sung Jidong J Cho BeLong B Kim Eung Soo ES Yu Byung-Yeon BY Lee Tae-Yong TY Kim Jong Sung JS Lee Yong-Jin YJ Oh Jang-Kyun JK Kim Sung Hi SH Park Jong-Ku JK Koh Sang Baek SB Park Sat Byul SB Lee Soon Young SY Yoo Cheol-In CI Kim Moon Chan MC Kim Hong-Kyu HK Park Joo-Sung JS Kim Hyeon Chang HC Lee Gyu Jang GJ Woodward Mark M
BMJ open 20140521 5
<h4>Objective</h4>The objectives of this study were to develop a coronary heart disease (CHD) risk model among the Korean Heart Study (KHS) population and compare it with the Framingham CHD risk score.<h4>Design</h4>A prospective cohort study within a national insurance system.<h4>Setting</h4>18 health promotion centres nationwide between 1996 and 2001 in Korea.<h4>Participants</h4>268 315 Koreans between the ages of 30 and 74 years without CHD at baseline.<h4>Outcome measure</h4>Non-fatal or fa ...[more]