Abstract

Objectives

To evaluate the predictive ability of the previously published NORRISK 2 cardiovascular risk model in Norwegian-born and immigrants born in South Asia living in Norway, and to add information about diabetes and ethnicity in an updated model for South Asians and diabetics (NORRISK 2-SADia). Design. We included participants (30–74 years) born in Norway (n = 13,885) or South Asia (n = 1942) from health surveys conducted in Oslo 2000–2003. Cardiovascular disease (CVD) risk factor information including self-reported diabetes was linked with information on subsequent acute myocardial infarction (AMI) and acute cerebral stroke in hospital and mortality registry data throughout 2014 from the nationwide CVDNOR project. We developed an updated model using Cox regression with diabetes and South Asian ethnicity as additional predictors. We assessed model performance by Harrell’s C and calibration plots. Results. The NORRISK 2 model underestimated the risk in South Asians in all quintiles of predicted risk. The mean predicted 13-year risk by the NORRISK 2 model was 3.9% (95% CI 3.7–4.2) versus observed 7.3% (95% CI 5.9–9.1) in South Asian men and 1.1% (95% CI 1.0–1.2) versus 2.7% (95% CI 1.7–4.2) observed risk in South Asian women. The mean predictions from the NORRISK 2-SADia model were 7.2% (95% CI 6.7–7.6) in South Asian men and 2.7% (95% CI 2.4–3.0) in South Asian women. Conclusions. The NORRISK 2-SADia model improved predictions of CVD substantially in South Asians, whose risks were underestimated by the NORRISK 2 model. The NORRISK 2-SADia model may facilitate more intense preventive measures in this high-risk population.

中文翻译：

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在南亚人和糖尿病患者中验证心血管风险模型 NORRISK 2

摘要

目标

评估先前发布的 NORRISK 2 心血管风险模型对挪威出生和居住在挪威的南亚移民的预测能力，并在更新的南亚人和糖尿病患者模型 (NORRISK 2-SADia) 中添加有关糖尿病和种族的信息）。设计。我们纳入了出生在挪威 ( n  = 13,885) 或南亚 ( n = 1942) 来自 2000-2003 年在奥斯陆进行的健康调查。包括自我报告的糖尿病在内的心血管疾病 (CVD) 危险因素信息与来自全国 CVDNOR 项目的 2014 年住院期间的后续急性心肌梗死 (AMI) 和急性脑卒中的信息以及死亡率登记数据相关联。我们使用 Cox 回归将糖尿病和南亚种族作为额外的预测因素开发了一个更新的模型。我们通过 Harrell's C 和校准图评估模型性能。结果。NORRISK 2 模型在预测风险的所有五分位数中都低估了南亚人的风险。NORRISK 2 模型预测的平均 13 年风险为 3.9%（95% CI 3.7-4.2），而南亚男性观察到的风险为 7.3%（95% CI 5.9-9.1）和 1.1%（95% CI 1.0-1.2）与 2.7% (95% CI 1.7–4.2) 在南亚女性中观察到的风险相比。NORRISK 2-SADia 模型的平均预测在南亚男性中为 7.2%（95% CI 6.7-7.6），在南亚女性中为 2.7%（95% CI 2.4-3.0）。结论。NORRISK 2-SADia 模型显着改善了南亚人对 CVD 的预测，而南亚人的风险被 NORRISK 2 模型低估了。NORRISK 2-SADia 模型可能有助于在这一高危人群中采取更严格的预防措施。