Revising Pooled Cohort Equations Improves CVD Risk Prediction
MONDAY, June 4, 2018 -- Revising the 2013 pooled cohort equations (PCEs) can improve accuracy of cardiovascular disease (CVD) risk prediction, according to a study published online June 5 in the Annals of Internal Medicine.
In an effort to improve the clinical accuracy of CVD risk prediction, Steve Yadlowsky, from Stanford University in California, and colleagues conducted a population-based study involving 26,689 adults aged 40 to 79 years without prior CVD from six U.S. cohorts.
The researchers found that across risk groups, the 2013 PCEs for atherosclerotic CVD overestimated 10-year risk by an average of 20 percent. Misestimation of risk was especially prominent among black adults; 33 percent of eligible black persons (3.9 million) had extreme risk estimates. Among all race and sex subgroups, accuracy was improved by updating these equations. Based on the updated equations, about 11.8 million U.S. adults previously labeled as high-risk by the 2013 PCEs would be relabeled as lower-risk.
"Updating the 2013 PCEs with data from modern cohorts reduced the number of persons considered to be at high risk. Clinicians and patients should consider the potential benefits and harms of reducing the number of persons recommended aspirin, blood pressure, or statin therapy," the authors write. "Our findings also indicate that risk equations will generally become outdated over time and require routine updating."
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Posted: June 2018