Coronary heart disease risk prediction in the Atherosclerosis Risk in Communities (ARIC) study

Lloyd E. Chambless, Aaron R. Folsom, A. Richey Sharrett, Paul Sorlie, David Couper, Moyses Szklo, F. Javier Nieto

Research output: Contribution to journalArticlepeer-review

239 Scopus citations

Abstract

Risk prediction functions for incident coronary heart disease (CHD) were estimated using data from the Atherosclerosis Risk in Communities (ARIC) Study, a prospective study of CHD in 15,792 persons recruited in 1987-1989 from four U.S. communities, with follow-up through 1998. Predictivity of which individuals had incident CHD was assessed by increase in area under ROC curves resulting from adding nontraditional risk factors and markers of subclinical disease to a basic model containing only traditional risk factors. We also assessed the increase in population attributable risk. The additional factors were body mass index; waist-hip ratio; sport activity index; forced expiratory volume; plasma fibrinogen, factor VIII, von Willebrand factor, and Lp(a); heart rate; Keys score; pack-years smoking; and subclinical disease marker carotid intima-media thickness. These factors substantially improved prediction of future CHD for men, less for women, and also increased attributable risks.

Original languageEnglish (US)
Pages (from-to)880-890
Number of pages11
JournalJournal of Clinical Epidemiology
Volume56
Issue number9
DOIs
StatePublished - Sep 1 2003

Bibliographical note

Funding Information:
The Atherosclerosis Risk in Communities Study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute contracts N01-HC-55015, N01-HC-55016, N01-HC-55018, N01-HC-55019, N01-HC-55020, N01-HC-55021, and N01-HC-55022. The authors thank the staff and participants of the ARIC study for their efforts, and thank Ernestine Bland for her word processing, Adam Gilbert for assistance in analysis, and Ding-yi Zhao and Yue Shen for their programming.

Keywords

  • Coronary heart disease
  • Population attributable risk
  • Prediction
  • ROC curves
  • Risk factors
  • Subclinical disease

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