Ethnicity and prediction of cardiovascular disease: performance of QRISK2 and Framingham scores in a UK tri-ethnic prospective cohort study (SABRE—Southall And Brent REvisited). Issue 1 (1st November 2013)

• Record Type: Journal Article
• Authors: Tillin, Therese; Hughes, Alun D; Whincup, Peter; Mayet, Jamil; Sattar, Naveed; McKeigue, Paul M; Chaturvedi, Nish
• Other Names: Chaturvedi Nish author non-byline.; Baker Mark author non-byline.; Beauchamp Norman author non-byline.; Coady Emma author non-byline.; Collins Rory author non-byline.; Forouhi Nita author non-byline.; Gedroyc Wladyslaw author non-byline.; Godsland Ian author non-byline.; Hattersley Andrew author non-byline.; Heasman John author non-byline.; Hughes Alun author non-byline.; Key Daniel author non-byline.; Majeed Azeem author non-byline.; March Katherine author non-byline.; Mayet Jamil author non-byline.; McGowan April author non-byline.; McKeigue Paul author non-byline.; Page Chloe author non-byline.; Prince Martin author non-byline.; Richards Marcus author non-byline.; Sattar Naveed author non-byline.; Shibata Dean author non-byline.; Stewart Robert author non-byline.; Tillin Therese author non-byline.; Tuson Claire author non-byline.; Whincup Peter author non-byline.; Willis Joe author non-byline.; Wright Andrew author non-byline.
• Is Part Of: Heart. Volume 100:Issue 1(2014)
• Page Start: 60
• Page End: 67
• Publication Date: 2013-11-01
• Subjects: Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heartjnl-2013-304474
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Objective: To evaluate QRISK2 and Framingham cardiovascular disease (CVD) risk scores in a tri-ethnic UK population. Design: Cohort study. Setting: West London. Participants: Randomly selected from primary care lists. Follow-up data were available for 87% of traced participants, comprising 1866 white Europeans, 1377 South Asians, and 578 African Caribbeans, aged 40–69 years at baseline (1998–1991). Main outcome measures: First CVD events: myocardial infarction, coronary revascularisation, angina, transient ischaemic attack or stroke reported by participant, primary care or hospital records or death certificate. Results: During follow-up, 387 CVD events occurred in men (14%) and 78 in women (8%). Both scores underestimated risk in European and South Asian women (ratio of predicted to observed risk: European women: QRISK2: 0.73, Framingham: 0.73; South Asian women: QRISK2: 0.52, Framingham: 0.43). In African Caribbeans, Framingham over-predicted in men and women and QRISK2 over-predicted in women. Framingham classified 28% of participants as high risk, predicting 54% of all such events. QRISK2 classified 19% as high risk, predicting 42% of all such events. Both scores performed poorly in identifying high risk African Caribbeans; QRISK2 and Framingham identified as high risk only 10% and 24% of those who experienced events. Conclusions: Neither score performed consistently well in all ethnic groups. Further validation of QRISK2 in other multi-ethnic datasets, and better methods for identifying high risk African Caribbeans and South Asian women, are required.