This study was published in the Journal of the American College of Cardiology 2016 May 10;67(18):2118-30
Study title and authors:
Accuracy of the Atherosclerotic Cardiovascular Risk Equation in a Large Contemporary, Multiethnic Population.
Rana JS, Tabada GH, Solomon MD, Lo JC, Jaffe MG, Sung SH, Ballantyne CM, Go AS.
Division of Cardiology, Kaiser Permanente Northern California, Oakland, California; Division of Research, Kaiser Permanente Northern California, Oakland, California; Department of Medicine, University of California, San Francisco, San Francisco, California.
The 2013 American College of Cardiology/American Heart Association (ACC/AHA) Pooled Cohort Equations calculator is used to estimate 10-year absolute risk for atherosclerotic cardiovascular disease (ASCVD) in primary prevention (people who have not developed clinically manifest cardiovascular disease).
The goal of this study was to evaluate the accuracy of the 2013 ACC/AHA Pooled Cohort Risk Equation. The study included 307,591 ethnically diverse adults without diabetes and not taking statins (aged 40-75 years) who were assessed over five years for or a total of 1,515,142 person-years.
The study found:
(a) Those with a predicted risk of up to 2.49% of having atherosclerotic cardiovascular disease events, only had an actual 0.20% risk.
(b) Those with a predicted risk between 2.50-3.74% of having atherosclerotic cardiovascular disease events, only had an actual 0.65% risk.
(c) Those with a predicted risk between 3.75-4.99% of having atherosclerotic cardiovascular disease events, only had an actual 0.90% risk.
(d) Those with a predicted risk of over 5.0% of having atherosclerotic cardiovascular disease events, only had an actual 1.85% risk.
Rana concluded: "In a large, contemporary "real-world" population, the ACC/AHA Pooled Cohort Risk Equation substantially overestimated actual 5-year risk in adults without diabetes, overall and across sociodemographic subgroups."
Senior author of the study, Dr Alan S. Go, chief of Cardiovascular and Metabolic Conditions Research at the Kaiser Permanente Northern California Division of Research, commented: "The (ACC/AHA Pooled Cohort Risk Equation) overestimation is approximately five- to six-fold... Translating this, it would mean that we would be over-treating a good many people based on the risk calculator... Our study provides critical evidence to support recalibration of the risk equation in 'real world' populations, especially given the individual and public health implications of the widespread application of this risk calculator."
