| アブストラクト | BACKGROUND: The Hisayama risk prediction model for atherosclerotic cardiovascular diseases (ASCVDs) has been featured in the latest Japanese preventive guidelines, yet it lacks external validation. METHODS: A retrospective cohort study of 420 552 ASCVD-free individuals aged 40-74 years was performed using data from the national health checkup and administrative claim database recorded between April 2015 and November 2020. Incident cases of ASCVD were ascertained from International Classification of Diseases, Tenth Revision (ICD-10) codes and accompanying medical practice codes. RESULTS: During a median follow-up of 4.4 years, 3998 individuals developed ASCVD. The Hisayama ASCVD model had good predictive performance in the setting of the Japanese national health checkup. The original model performed well for estimating relative risks (hazard ratio, 32.73 [95% CI, 24.59-43.55] in the highest versus lowest decile) with a satisfactory discriminative ability (Uno's C-statistic, 0.759 [95% CI, 0.751-0.766]), while it tended to overestimate the predicted probability of ASCVD for the study population (calibration-in-the-large, 0.42 [95% CI, 0.41-0.44]). Improved performance was observed after recalibration by substituting the baseline survival rate (calibration-in-the-large, 1.00 [95% CI, 0.97-1.04]) and by refitting the model (calibration-in-the-large, 1.00 [95% CI, 0.97-1.03]; Uno's C-statistic, 0.766 [95% CI, 0.759-0.774]). The predictive performance was good across subgroups of age, sex, and type of insurance. CONCLUSIONS: This external validation study demonstrated that the Hisayama ASCVD model had good predictive performance in the national health checkup setting in Japan, suggesting the use of the Hisayama ASCVD model for efficient risk stratification and risk communication in the nationwide health checkups. |
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| ジャーナル名 | Journal of the American Heart Association |
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| Pubmed追加日 | 2025/7/30 |
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| 投稿者 | Honda, Takanori; Furuta, Yoshihiko; Maezono, Akihiro; Chen, Sanmei; Ishida, Yuki; Furuhashi, Hiroko; Kumamoto, Masaya; Oishi, Emi; Kimura, Yasumi; Yoshida, Daigo; Ninomiya, Toshiharu |
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| 組織名 | Center for Cohort Studies, Graduate School of Medical Sciences Kyushu University;Fukuoka Japan.;Department of Epidemiology and Public Health, Graduate School of Medical Sciences;Kyushu University Fukuoka Japan.;Department of Medicine and Clinical Science, Graduate School of Medical Sciences;Department of Cardiovascular Medicine, Graduate School of Medical Sciences Kyushu;University Fukuoka Japan.;Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima;Japan.;Department of Psychology, Faculty of Literature Kurume University Kurume Japan.;Laboratory for Genotyping Development RIKEN Center for Integrative Medical;Sciences Kanagawa Japan.;Department of Health Nutrition, Faculty of Health Sciences Hiroshima Shudo;University Hiroshima Japan.;Division of Community Health and Home Care Nursing, Graduate School of Nursing;Fukuoka Nursing College Fukuoka Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/40736084/ |
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