Prediction of individual lifetime cardiovascular risk and potential treatment benefit: development and recalibration of the LIFE-CVD2 model to four European risk regions.

Autor:	Hageman SHJ; Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands., Kaptoge S; Department of Public Health and Primary Care, University of Cambridge, CambridgeUK., de Vries TI; Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands., Lu W; Department of Epidemiology and Public Health, University College London, London, UK., Kist JM; Health Campus The Hague, Leiden University Medical Center, The Hague, the Netherlands.; National eHealth Living Lab, Leiden University Medical Center, The Hague, the Netherlands., van Os HJA; Health Campus The Hague, Leiden University Medical Center, The Hague, the Netherlands., Numans ME; Health Campus The Hague, Leiden University Medical Center, The Hague, the Netherlands., Läll K; Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia., Bobak M; Department of Epidemiology and Public Health, University College London, London, UK.; RECETOX, Masaryk University, Brno, Czech Republic., Pikhart H; Department of Epidemiology and Public Health, University College London, London, UK.; RECETOX, Masaryk University, Brno, Czech Republic., Kubinova R; National Institute of Public Health, Prague, Czech Republic., Malyutina S; Independent Researcher., Pająk A; Department of Epidemiology and Population Studies, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland., Tamosiunas A; Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania., Erbel R; Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany., Stang A; Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany., Schmidt B; Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany., Schramm S; Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany., Bolton TR; British Heart Foundation Data Science Centre, Health Data Research UK, London, UK.; British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK., Spackman S; British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.; Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, CambridgeUK., Bakker SJL; Department of Internal Medicine, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands., Blaha M; Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins Hospital, Baltimore, MD, USA., Boer JMA; Centre for Prevention, Lifestyle and Health, National Institute for Public Health and the Environment, Bilthoven, The Netherlands., Bonnefond A; Inserm/CNRS UMR 1283/8199, Pasteur Institute of Lille, EGID, Lille, France.; University of Lille, Lille, France; Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK., Brenner H; Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany.; Network Aging Research, University of Heidelberg, Heidelberg, Germany., Brunner EJ; Department of Epidemiology and Public Health, University College London, London, UK., Cook NR; Brigham & Women's Hospital, Harvard Medical School Harvard University, Boston, MA, USA., Davidson K; Feinstein Institutes for Medical Research, Northwell Health, New York, NY, USA., Dennison E; MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK., Donfrancesco C; Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanita', Rome, Italy., Dörr M; Institute for Community Medicine, University Medicine Greifswald, University of Greifswald, Greifswald, Germany.; German Centre for Cardiovascular Disease (DZHK), Partner Site Greifswald.; German Centre for Cardiovascular Disease (DZD), Site Greifswald, Greifswald, Germany., Floyd JS; Cardiovascular Health Research Unit, Departments of Medicine and Epidemiology, University of Washington, Seattle, WA, USA., Ford I; Robertson Center for Biostatistics, University of Glasgow, Glasgow, UK., Fu M; Department of Medicine, Sahlgrenska University Hospital/Östra Hospital, Gothenburg, Sweden., Gansevoort RT; Department of Internal Medicine, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands., Giampaoli S; former Istituto Superiore di Sanità, Rome, Italy., Gillum RF; Howard University Hospital, Washington, DC, USA., Gómez-de-la-Cámara A; Instituto de Investigación Hospital 12 de Octubre, Madrid, Spain., Håheim LL; Institute of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway., Hansson PO; Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden., Harms P; Department of General Practice, Amsterdam University Medical Center, Amsterdam, Netherlands., Humphries SE; Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, UK., Ikram MK; Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands., Jukema JW; Department of Cardiology, Leiden University Medical Center, The Netherlands.; Netherlands Heart Institute, Leiden, the Netherlands., Kavousi M; Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands., Kiechl S; Department of Neurology, Innsbruck Medical University and VASCage, Research Centre on Vascular Ageing and Stroke, Innsbruck, Austria., Kucharska-Newton A; College of Public Health, Department of Epidemiology, University of Kentucky, KY, USA., Pablos DL; Instituto de Investigación Hospital 12 de Octubre, Universidad Complutense de Madrid (UCM), Madrid, Spain., Matsushita K; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA., Meyer HE; Norwegian Institute of Public Health, Oslo, Norway., Moons KGM; Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Utrecht, The Netherlands., Mortensen MB; Department of Clinical Biochemistry, Copenhagen University Hospital - Herlev Gentofte, Copenhagen, Denmark.; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark., Muilwijk M; Department of Epidemiology and Data Science, Amsterdam University Medical Center, Amsterdam, Netherlands., Nordestgaard BG; Department of Clinical Biochemistry, Copenhagen University Hospital - Herlev Gentofte, Copenhagen, Denmark.; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark., Packard C; School of Cardiovascular & Metabolic Health, University of Glasgow, Glasgow, UK., Pamieri L; Department of Cardiovascular, Dysmetabolic and Aging-associated Diseases, Istituto Superiore di Sanità, Rome, Italy., Panagiotakos D; Harokopio University, Athens, Greece., Peters A; Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.; IBE, Pettenkofer School of Public Health, Medical Faculty, Ludwig-Maximilians-Universität, Munich, Germany.; German Centre for Cardiovascular Research (DZHK e.V.), partner site Munich Heart Alliance, Munich, Germany., Potier L; Université Paris City, Paris, France.; Department of Diabetology, Endocrinology and Nutrition, Assistance Publique - Hôpitaux de Paris, Bichat Hospital, Paris, France., Providencia R; Institute of Health Informatics Research, University College London, London, UK., Psaty BM; Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA., Ridker PM; Brigham & Women's Hospital, Harvard Medical School Harvard University, Boston, MA, USA., Rodriguez B; University of Hawaii and Tecnologico de Monterrey, Honolulu, HI, USA., Rosengren A; Sahlgrenska University Hospital and Östra Hospital, Göteborg, Sweden., Sattar N; School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK., Schöttker B; Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany.; Network Aging Research, University of Heidelberg, Heidelberg, Germany., Schwartz JE; Columbia University, New York, NY, USA., Shea S; College of Physicians & Surgeons and Mailman School of Public Health, Columbia University, NY, USA., Shipley MJ; Department of Epidemiology and Public Health, University College London, London, UK., Sofat R; Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, UK., Thorand B; Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.; IBE, Pettenkofer School of Public Health, Medical Faculty, Ludwig-Maximilians-Universität, Munich, Germany., Verschuren WMM; Centre for Prevention, Lifestyle and Health, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.; Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Utrecht, The Netherlands., Völzke H; Institute for Community Medicine, University Medicine Greifswald, University of Greifswald, Greifswald, Germany.; German Centre for Cardiovascular Disease (DZHK), Partner Site Greifswald.; German Centre for Cardiovascular Disease (DZD), Site Greifswald, Greifswald, Germany., Wareham NJ; MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, University of Cambridge, Cambridge, UK., Westbury L; MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK., Willeit P; British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.; Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, Innsbruck, Austria., Zhou B; Faculty of Medicine, School of Public Health, Imperial College London, London, UK., Danesh J; British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.; Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, CambridgeUK., Visseren FLJ; Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands., Di Angelantonio E; Department of Public Health and Primary Care, University of Cambridge, CambridgeUK., Pennells L; Department of Public Health and Primary Care, University of Cambridge, CambridgeUK., Dorresteijn JAN; Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
Jazyk:	angličtina
Zdroj:	European journal of preventive cardiology [Eur J Prev Cardiol] 2024 Oct 10; Vol. 31 (14), pp. 1690-1699.
DOI:	10.1093/eurjpc/zwae174
Abstrakt:	Aims: The 2021 European Society of Cardiology prevention guidelines recommend the use of (lifetime) risk prediction models to aid decisions regarding initiation of prevention. We aimed to update and systematically recalibrate the LIFEtime-perspective CardioVascular Disease (LIFE-CVD) model to four European risk regions for the estimation of lifetime CVD risk for apparently healthy individuals. Methods and Results: The updated LIFE-CVD (i.e. LIFE-CVD2) models were derived using individual participant data from 44 cohorts in 13 countries (687 135 individuals without established CVD, 30 939 CVD events in median 10.7 years of follow-up). LIFE-CVD2 uses sex-specific functions to estimate the lifetime risk of fatal and non-fatal CVD events with adjustment for the competing risk of non-CVD death and is systematically recalibrated to four distinct European risk regions. The updated models showed good discrimination in external validation among 1 657 707 individuals (61 311 CVD events) from eight additional European cohorts in seven countries, with a pooled C-index of 0.795 (95% confidence interval 0.767-0.822). Predicted and observed CVD event risks were well calibrated in population-wide electronic health records data in the UK (Clinical Practice Research Datalink) and the Netherlands (Extramural LUMC Academic Network). When using LIFE-CVD2 to estimate potential gain in CVD-free life expectancy from preventive therapy, projections varied by risk region reflecting important regional differences in absolute lifetime risk. For example, a 50-year-old smoking woman with a systolic blood pressure (SBP) of 140 mmHg was estimated to gain 0.9 years in the low-risk region vs. 1.6 years in the very high-risk region from lifelong 10 mmHg SBP reduction. The benefit of smoking cessation for this individual ranged from 3.6 years in the low-risk region to 4.8 years in the very high-risk region. Conclusion: By taking into account geographical differences in CVD incidence using contemporary representative data sources, the recalibrated LIFE-CVD2 model provides a more accurate tool for the prediction of lifetime risk and CVD-free life expectancy for individuals without previous CVD, facilitating shared decision-making for cardiovascular prevention as recommended by 2021 European guidelines. Competing Interests: Conflict of interest: Due to the very long author list, these will be provided per author using ICMJE forms at the revision stage, if applicable. (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Databáze:	MEDLINE
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