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Are the Framingham and PROCAM coronary heart disease risk functions applicable to different European populations? The PRIME Study.
Eur Heart J 2003; 24(21):1903-11EH

Abstract

AIMS

To assess whether the Framingham and PROCAM risk functions were applicable to men in Belfast and France.

METHODS AND RESULTS

We performed an external validation study within the PRIME (Prospective Epidemiological Study of Myocardial Infarction) cohort study. It comprised men recruited in Belfast (2399) and France (7359) who were aged 50 to 59 years, free of CHD at baseline (1991 to 1993) and followed over 5 years for CHD events (coronary death, myocardial infarction, angina pectoris). We compared the relative risks of CHD associated with the classic risk factors in PRIME with those in Framingham and PROCAM cohorts. We then compared the number of predicted and observed 5-year CHD events (calibration). Finally, we estimated the ability of the risk functions to separate high risk from low risk subjects (discrimination). The relative risk of CHD calculated for the various factors in the PRIME population were not statistically different from those published in the Framingham and PROCAM risk functions. The number of CHD events predicted by these risk functions however clearly overestimated those observed in Belfast and France. The two risk functions had a similar ability to separate high risk from low risk subjects in Belfast and France (c-statistic range: 0.61-0.68).

CONCLUSION

The Framingham and PROCAM risk functions should not be used to estimate the absolute CHD risk of middle-aged men in Belfast and France without any CHD history because of a clear overestimation. Specific population risk functions are needed.

Authors+Show Affiliations

Lille MONICA Project, INSERM U508, Institut Pasteur de Lille, Lille, France. empana@vjf.inserm.fr

Pub Type(s)

Comparative Study
Evaluation Studies
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Validation Studies

Language

eng

PubMed ID

14585248

Citation

Empana, J P., et al. "Are the Framingham and PROCAM Coronary Heart Disease Risk Functions Applicable to Different European Populations? the PRIME Study." European Heart Journal, vol. 24, no. 21, 2003, pp. 1903-11.
Empana JP, Ducimetière P, Arveiler D, et al. Are the Framingham and PROCAM coronary heart disease risk functions applicable to different European populations? The PRIME Study. Eur Heart J. 2003;24(21):1903-11.
Empana, J. P., Ducimetière, P., Arveiler, D., Ferrières, J., Evans, A., Ruidavets, J. B., ... Dallongeville, J. (2003). Are the Framingham and PROCAM coronary heart disease risk functions applicable to different European populations? The PRIME Study. European Heart Journal, 24(21), pp. 1903-11.
Empana JP, et al. Are the Framingham and PROCAM Coronary Heart Disease Risk Functions Applicable to Different European Populations? the PRIME Study. Eur Heart J. 2003;24(21):1903-11. PubMed PMID: 14585248.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Are the Framingham and PROCAM coronary heart disease risk functions applicable to different European populations? The PRIME Study. AU - Empana,J P, AU - Ducimetière,P, AU - Arveiler,D, AU - Ferrières,J, AU - Evans,A, AU - Ruidavets,J B, AU - Haas,B, AU - Yarnell,J, AU - Bingham,A, AU - Amouyel,P, AU - Dallongeville,J, AU - ,, PY - 2003/10/31/pubmed PY - 2004/2/11/medline PY - 2003/10/31/entrez SP - 1903 EP - 11 JF - European heart journal JO - Eur. Heart J. VL - 24 IS - 21 N2 - AIMS: To assess whether the Framingham and PROCAM risk functions were applicable to men in Belfast and France. METHODS AND RESULTS: We performed an external validation study within the PRIME (Prospective Epidemiological Study of Myocardial Infarction) cohort study. It comprised men recruited in Belfast (2399) and France (7359) who were aged 50 to 59 years, free of CHD at baseline (1991 to 1993) and followed over 5 years for CHD events (coronary death, myocardial infarction, angina pectoris). We compared the relative risks of CHD associated with the classic risk factors in PRIME with those in Framingham and PROCAM cohorts. We then compared the number of predicted and observed 5-year CHD events (calibration). Finally, we estimated the ability of the risk functions to separate high risk from low risk subjects (discrimination). The relative risk of CHD calculated for the various factors in the PRIME population were not statistically different from those published in the Framingham and PROCAM risk functions. The number of CHD events predicted by these risk functions however clearly overestimated those observed in Belfast and France. The two risk functions had a similar ability to separate high risk from low risk subjects in Belfast and France (c-statistic range: 0.61-0.68). CONCLUSION: The Framingham and PROCAM risk functions should not be used to estimate the absolute CHD risk of middle-aged men in Belfast and France without any CHD history because of a clear overestimation. Specific population risk functions are needed. SN - 0195-668X UR - https://www.unboundmedicine.com/medline/citation/14585248/Are_the_Framingham_and_PROCAM_coronary_heart_disease_risk_functions_applicable_to_different_European_populations_The_PRIME_Study_ L2 - https://academic.oup.com/eurheartj/article-lookup/doi/10.1016/j.ehj.2003.09.002 DB - PRIME DP - Unbound Medicine ER -