Development and validation of an ankle brachial index risk model for the prediction of cardiovascular events
Identifieur interne : 005968 ( Main/Merge ); précédent : 005967; suivant : 005969Development and validation of an ankle brachial index risk model for the prediction of cardiovascular events
Auteurs : F. G. R. Fowkes [Royaume-Uni] ; G. D. Murray [Royaume-Uni] ; I. Butcher [Royaume-Uni] ; A. R. Folsom [États-Unis] ; A. T. Hirsch [États-Unis] ; D. J. Couper [États-Unis] ; G. Debacker [Belgique] ; M. Kornitzer [Belgique] ; A. B. Newman [États-Unis] ; K. C. Sutton-Tyrrell [États-Unis] ; M. Cushman [États-Unis] ; A. J. Lee [Royaume-Uni] ; J. F. Price [Royaume-Uni] ; R. B. Sr D'Agostino [États-Unis] ; J. M. Murabito [États-Unis] ; P. E. Norman [Australie] ; K. H. Masaki [États-Unis] ; L. M. Bouter [Pays-Bas] ; R. J. Heine [Pays-Bas] ; C. D. A. Stehouwer [Pays-Bas] ; M. M. Mcdermott [États-Unis] ; H. E. J. H. Stoffers [Pays-Bas] ; J. A. Knottnerus [Pays-Bas] ; M. Ogren [Suède] ; B. Hedblad [Suède] ; W. Koenig [Allemagne] ; C. Meisinger [Allemagne] ; J. A. Cauley [États-Unis] ; O. H. Franco [Pays-Bas] ; M. G. M. Hunink [Pays-Bas] ; A. Hofman [Pays-Bas] ; J. C. Witteman [Pays-Bas] ; M. H. Criqui [États-Unis] ; R. D. Langer [États-Unis] ; W. R. Hiatt ; R. F. HammanSource :
- European journal of preventive cardiology : (Print) [ 2047-4873 ] ; 2014.
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Abstract
Background: The ankle brachial index (ABI) is related to risk of cardiovascular events independent of the Framingham risk score (FRS). The aim of this study was to develop and evaluate a risk model for cardiovascular events incorporating the ABI and FRS. Design: An analysis of participant data from 18 cohorts in which 24,375 men and 20,377 women free of coronary heart disease had ABI measured and were followed up for events. Methods: Subjects were divided into a development and internal validation dataset and an external validation dataset. Two models, comprising FRS and FRS + ABI, were fitted for the primary outcome of major coronary events. Results: In predicting events in the external validation dataset, C-index for the FRS was 0.672 (95% CI 0.599 to 0.737) in men and 0.578 (95% CI 0.492 to 0.661) in women. The FRS + ABI led to a small increase in C-index in men to 0.685 (95% CI 0.612 to 0.749) and large increase in women to 0.690 (95% CI 0.605 to 0.764) with net reclassification improvement (NRI) of 4.3% (95% CI 0.0 to 7.6%, p=0.050) and 9.6% (95% CI 6.1 to 16.4%, p <0.001), respectively. Restricting the FRS + ABI model to those with FRS intermediate 10-year risk of 10 to 19% resulted in higher NRI of 15.9% (95% CI 6.1 to 20.6%, p < 0.001) in men and 23.3% (95% CI 13.8 to 62.5%, p = 0.002) in women. However, incorporating ABI in an improved newly fitted risk factor model had a nonsignificant effect: NRI 2.0% (95% CI 2.3 to 4.2%, p=0.567) in men and 1.1% (95% CI 1.9 to 4.0%, p=0.483) in women.
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Newman</name><affiliation wicri:level="4"><inist:fA14 i1="07"><s1>Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh</s1><s2>Pittsburgh, PA</s2><s3>USA</s3><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>28 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Pittsburgh</settlement><region type="state">Pennsylvanie</region></placeName><orgName type="university">Université de Pittsburgh</orgName></affiliation></author><author><name sortKey="Sutton Tyrrell, K C" sort="Sutton Tyrrell, K C" uniqKey="Sutton Tyrrell K" first="K. C." last="Sutton-Tyrrell">K. C. 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Norman</name><affiliation wicri:level="1"><inist:fA14 i1="12"><s1>School of Surgery, University of Western Australia</s1><s2>Perth</s2><s3>AUS</s3><sZ>16 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Perth</wicri:noRegion></affiliation></author><author><name sortKey="Masaki, K H" sort="Masaki, K H" uniqKey="Masaki K" first="K. H." last="Masaki">K. H. Masaki</name><affiliation wicri:level="1"><inist:fA14 i1="13"><s1>Department of Geriatric Medicine, John A Burns School of Medicine, University of Hawaii</s1><s2>Honolulu,HI</s2><s3>USA</s3><sZ>17 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Honolulu,HI</wicri:noRegion></affiliation></author><author><name sortKey="Bouter, L M" sort="Bouter, L M" uniqKey="Bouter L" first="L. M." last="Bouter">L. M. Bouter</name><affiliation wicri:level="3"><inist:fA14 i1="14"><s1>Executive Board, VU University Amsterdam</s1><s2>Amsterdam</s2><s3>NLD</s3><sZ>18 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName></affiliation></author><author><name sortKey="Heine, R J" sort="Heine, R J" uniqKey="Heine R" first="R. J." last="Heine">R. J. Heine</name><affiliation wicri:level="3"><inist:fA14 i1="15"><s1>Diabetes Center, VU University Medical Center</s1><s2>Amsterdam</s2><s3>NLD</s3><sZ>19 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName></affiliation></author><author><name sortKey="Stehouwer, C D A" sort="Stehouwer, C D A" uniqKey="Stehouwer C" first="C. D. A." last="Stehouwer">C. D. A. Stehouwer</name><affiliation wicri:level="1"><inist:fA14 i1="16"><s1>Department of Internal Medicine, Maastricht University Medical Centre</s1><s2>Maastricht</s2><s3>NLD</s3><sZ>20 aut.</sZ></inist:fA14><country>Pays-Bas</country><wicri:noRegion>Maastricht</wicri:noRegion></affiliation></author><author><name sortKey="Mcdermott, M M" sort="Mcdermott, M M" uniqKey="Mcdermott M" first="M. M." last="Mcdermott">M. M. Mcdermott</name><affiliation wicri:level="1"><inist:fA14 i1="17"><s1>Department of Medicine, Northwestern University Feinberg School of Medicine</s1><s2>Chicago, IL</s2><s3>USA</s3><sZ>21 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Chicago, IL</wicri:noRegion></affiliation></author><author><name sortKey="Stoffers, H E J H" sort="Stoffers, H E J H" uniqKey="Stoffers H" first="H. E. J. H" last="Stoffers">H. E. J. H. Stoffers</name><affiliation wicri:level="1"><inist:fA14 i1="18"><s1>Department of General Practice/Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre</s1><s2>Maastricht</s2><s3>NLD</s3><sZ>22 aut.</sZ><sZ>23 aut.</sZ></inist:fA14><country>Pays-Bas</country><wicri:noRegion>Maastricht</wicri:noRegion></affiliation></author><author><name sortKey="Knottnerus, J A" sort="Knottnerus, J A" uniqKey="Knottnerus J" first="J. A." last="Knottnerus">J. A. Knottnerus</name><affiliation wicri:level="1"><inist:fA14 i1="18"><s1>Department of General Practice/Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre</s1><s2>Maastricht</s2><s3>NLD</s3><sZ>22 aut.</sZ><sZ>23 aut.</sZ></inist:fA14><country>Pays-Bas</country><wicri:noRegion>Maastricht</wicri:noRegion></affiliation></author><author><name sortKey="Ogren, M" sort="Ogren, M" uniqKey="Ogren M" first="M." last="Ogren">M. Ogren</name><affiliation wicri:level="4"><inist:fA14 i1="19"><s1>Department of Surgical Sciences (Vascular Surgery), Uppsala University</s1><s2>Uppsala</s2><s3>SWE</s3><sZ>24 aut.</sZ></inist:fA14><country>Suède</country><placeName><settlement type="city">Uppsala</settlement><region nuts="1">Svealand</region><region nuts="1">East Middle Sweden</region></placeName><orgName type="university">Université d'Uppsala</orgName></affiliation></author><author><name sortKey="Hedblad, B" sort="Hedblad, B" uniqKey="Hedblad B" first="B." last="Hedblad">B. Hedblad</name><affiliation wicri:level="1"><inist:fA14 i1="20"><s1>Department of Clinical Sciences, Skane University Hospital, Lund University</s1><s2>Malmo</s2><s3>SWE</s3><sZ>25 aut.</sZ></inist:fA14><country>Suède</country><wicri:noRegion>Malmo</wicri:noRegion></affiliation></author><author><name sortKey="Koenig, W" sort="Koenig, W" uniqKey="Koenig W" first="W." last="Koenig">W. Koenig</name><affiliation wicri:level="3"><inist:fA14 i1="21"><s1>Department of Internal Medicine II - Cardiology, University of Ulm Medical Center</s1><s2>Ulm</s2><s3>DEU</s3><sZ>26 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Tübingen</region><settlement type="city">Ulm</settlement></placeName></affiliation></author><author><name sortKey="Meisinger, C" sort="Meisinger, C" uniqKey="Meisinger C" first="C." last="Meisinger">C. Meisinger</name><affiliation wicri:level="1"><inist:fA14 i1="22"><s1>Institute of Epidemiology II, Helmholtz Zentrum Munchen</s1><s2>Neuherberg</s2><s3>DEU</s3><sZ>27 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Neuherberg</wicri:noRegion><wicri:noRegion>Helmholtz Zentrum Munchen</wicri:noRegion><wicri:noRegion>Neuherberg</wicri:noRegion></affiliation></author><author><name sortKey="Cauley, J A" sort="Cauley, J A" uniqKey="Cauley J" first="J. A." last="Cauley">J. A. Cauley</name><affiliation wicri:level="4"><inist:fA14 i1="07"><s1>Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh</s1><s2>Pittsburgh, PA</s2><s3>USA</s3><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>28 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Pittsburgh</settlement><region type="state">Pennsylvanie</region></placeName><orgName type="university">Université de Pittsburgh</orgName></affiliation></author><author><name sortKey="Franco, O H" sort="Franco, O H" uniqKey="Franco O" first="O. H." last="Franco">O. H. Franco</name><affiliation wicri:level="3"><inist:fA14 i1="23"><s1>Department of Epidemiology, Erasmus MC</s1><s2>Rotterdam</s2><s3>NLD</s3><sZ>29 aut.</sZ><sZ>30 aut.</sZ><sZ>31 aut.</sZ><sZ>32 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Hunink, M G M" sort="Hunink, M G M" uniqKey="Hunink M" first="M. G. M." last="Hunink">M. G. M. Hunink</name><affiliation wicri:level="3"><inist:fA14 i1="23"><s1>Department of Epidemiology, Erasmus MC</s1><s2>Rotterdam</s2><s3>NLD</s3><sZ>29 aut.</sZ><sZ>30 aut.</sZ><sZ>31 aut.</sZ><sZ>32 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Hofman, A" sort="Hofman, A" uniqKey="Hofman A" first="A." last="Hofman">A. Hofman</name><affiliation wicri:level="3"><inist:fA14 i1="23"><s1>Department of Epidemiology, Erasmus MC</s1><s2>Rotterdam</s2><s3>NLD</s3><sZ>29 aut.</sZ><sZ>30 aut.</sZ><sZ>31 aut.</sZ><sZ>32 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Witteman, J C" sort="Witteman, J C" uniqKey="Witteman J" first="J. C." last="Witteman">J. C. Witteman</name><affiliation wicri:level="3"><inist:fA14 i1="23"><s1>Department of Epidemiology, Erasmus MC</s1><s2>Rotterdam</s2><s3>NLD</s3><sZ>29 aut.</sZ><sZ>30 aut.</sZ><sZ>31 aut.</sZ><sZ>32 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Criqui, M H" sort="Criqui, M H" uniqKey="Criqui M" first="M. H." last="Criqui">M. H. Criqui</name><affiliation wicri:level="1"><inist:fA14 i1="24"><s1>Department of Family and Preventive Medicine, University of California San Diego</s1><s2>La Jolla, CA</s2><s3>USA</s3><sZ>33 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>La Jolla, CA</wicri:noRegion></affiliation></author><author><name sortKey="Langer, R D" sort="Langer, R D" uniqKey="Langer R" first="R. D." last="Langer">R. D. Langer</name><affiliation wicri:level="1"><inist:fA14 i1="25"><s1>Department of Family Medicine - Las Vegas, University of Nevada School of Medicine</s1><s2>Las Vegas, NV</s2><s3>USA</s3><sZ>34 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Las Vegas, NV</wicri:noRegion></affiliation></author><author><name sortKey="Hiatt, W R" sort="Hiatt, W R" uniqKey="Hiatt W" first="W. R." last="Hiatt">W. R. Hiatt</name></author><author><name sortKey="Hamman, R F" sort="Hamman, R F" uniqKey="Hamman R" first="R. F." last="Hamman">R. F. Hamman</name></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">14-0084230</idno><date when="2014">2014</date><idno type="stanalyst">PASCAL 14-0084230 INIST</idno><idno type="RBID">Pascal:14-0084230</idno><idno type="wicri:Area/PascalFrancis/Corpus">000D62</idno><idno type="wicri:Area/PascalFrancis/Curation">003847</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000A45</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000A45</idno><idno type="wicri:doubleKey">2047-4873:2014:Fowkes F:development:and:validation</idno><idno type="wicri:Area/Main/Merge">005968</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Development and validation of an ankle brachial index risk model for the prediction of cardiovascular events</title><author><name sortKey="Fowkes, F G R" sort="Fowkes, F G R" uniqKey="Fowkes F" first="F. G. R." last="Fowkes">F. G. R. Fowkes</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Centre for Population Health Sciences, University of Edinburgh</s1><s2>Edinburgh</s2><s3>GBR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Édimbourg</settlement><region type="country">Écosse</region><settlement type="city">Édimbourg</settlement></placeName><orgName type="university">Université d'Édimbourg</orgName></affiliation></author><author><name sortKey="Murray, G D" sort="Murray, G D" uniqKey="Murray G" first="G. D." last="Murray">G. D. Murray</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Centre for Population Health Sciences, University of Edinburgh</s1><s2>Edinburgh</s2><s3>GBR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Édimbourg</settlement><region type="country">Écosse</region><settlement type="city">Édimbourg</settlement></placeName><orgName type="university">Université d'Édimbourg</orgName></affiliation></author><author><name sortKey="Butcher, I" sort="Butcher, I" uniqKey="Butcher I" first="I." last="Butcher">I. Butcher</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Centre for Population Health Sciences, University of Edinburgh</s1><s2>Edinburgh</s2><s3>GBR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Édimbourg</settlement><region type="country">Écosse</region><settlement type="city">Édimbourg</settlement></placeName><orgName type="university">Université d'Édimbourg</orgName></affiliation></author><author><name sortKey="Folsom, A R" sort="Folsom, A R" uniqKey="Folsom A" first="A. R." last="Folsom">A. R. Folsom</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Division of Epidemiology and Community Health, University of Minnesota</s1><s2>Minneapolis, MN</s2><s3>USA</s3><sZ>4 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Minneapolis, MN</wicri:noRegion></affiliation></author><author><name sortKey="Hirsch, A T" sort="Hirsch, A T" uniqKey="Hirsch A" first="A. T." last="Hirsch">A. T. Hirsch</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Cardiovascular Division, Lillehei Heart Institute, University of Minnesota Medical School</s1><s2>Minneapolis, MN</s2><s3>USA</s3><sZ>5 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Minneapolis, MN</wicri:noRegion></affiliation></author><author><name sortKey="Couper, D J" sort="Couper, D J" uniqKey="Couper D" first="D. J." last="Couper">D. J. Couper</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Department of Biostatistics, University of North Carolina</s1><s2>Chapel Hill, NC</s2><s3>USA</s3><sZ>6 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Chapel Hill, NC</wicri:noRegion></affiliation></author><author><name sortKey="Debacker, G" sort="Debacker, G" uniqKey="Debacker G" first="G." last="Debacker">G. Debacker</name><affiliation wicri:level="4"><inist:fA14 i1="05"><s1>Department of Public Health, Ghent University</s1><s2>Ghent</s2><s3>BEL</s3><sZ>7 aut.</sZ></inist:fA14><country>Belgique</country><placeName><settlement type="city">Gand</settlement><region>Région flamande</region><region type="district" nuts="2">Province de Flandre-Orientale</region></placeName><orgName type="university">Université de Gand</orgName></affiliation></author><author><name sortKey="Kornitzer, M" sort="Kornitzer, M" uniqKey="Kornitzer M" first="M." last="Kornitzer">M. Kornitzer</name><affiliation wicri:level="4"><inist:fA14 i1="06"><s1>School of Public Health, Universite Libre de Bruxelles</s1><s2>Brussels</s2><s3>BEL</s3><sZ>8 aut.</sZ></inist:fA14><country>Belgique</country><placeName><settlement type="city">Bruxelles</settlement><region nuts="2">Région de Bruxelles-Capitale</region><settlement type="city">Bruxelles</settlement></placeName><orgName type="university">Université libre de Bruxelles</orgName></affiliation></author><author><name sortKey="Newman, A B" sort="Newman, A B" uniqKey="Newman A" first="A. B." last="Newman">A. B. Newman</name><affiliation wicri:level="4"><inist:fA14 i1="07"><s1>Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh</s1><s2>Pittsburgh, PA</s2><s3>USA</s3><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>28 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Pittsburgh</settlement><region type="state">Pennsylvanie</region></placeName><orgName type="university">Université de Pittsburgh</orgName></affiliation></author><author><name sortKey="Sutton Tyrrell, K C" sort="Sutton Tyrrell, K C" uniqKey="Sutton Tyrrell K" first="K. C." last="Sutton-Tyrrell">K. C. Sutton-Tyrrell</name><affiliation wicri:level="4"><inist:fA14 i1="07"><s1>Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh</s1><s2>Pittsburgh, PA</s2><s3>USA</s3><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>28 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Pittsburgh</settlement><region type="state">Pennsylvanie</region></placeName><orgName type="university">Université de Pittsburgh</orgName></affiliation></author><author><name sortKey="Cushman, M" sort="Cushman, M" uniqKey="Cushman M" first="M." last="Cushman">M. Cushman</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Department of Medicine, University of Vermont</s1><s2>Burlington, VT</s2><s3>USA</s3><sZ>11 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Burlington, VT</wicri:noRegion></affiliation></author><author><name sortKey="Lee, A J" sort="Lee, A J" uniqKey="Lee A" first="A. J." last="Lee">A. J. Lee</name><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Section of Population Health, University of Aberdeen</s1><s2>Aberdeen</s2><s3>GBR</s3><sZ>12 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Aberdeen</wicri:noRegion></affiliation></author><author><name sortKey="Price, J F" sort="Price, J F" uniqKey="Price J" first="J. F." last="Price">J. F. Price</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Centre for Population Health Sciences, University of Edinburgh</s1><s2>Edinburgh</s2><s3>GBR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Édimbourg</settlement><region type="country">Écosse</region><settlement type="city">Édimbourg</settlement></placeName><orgName type="university">Université d'Édimbourg</orgName></affiliation></author><author><name sortKey="D Agostino, R B Sr" sort="D Agostino, R B Sr" uniqKey="D Agostino R" first="R. B. Sr" last="D'Agostino">R. B. Sr D'Agostino</name><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>Mathematics and Statistics Department, Boston University</s1><s2>Boston, MA</s2><s3>USA</s3><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Boston, MA</wicri:noRegion></affiliation></author><author><name sortKey="Murabito, J M" sort="Murabito, J M" uniqKey="Murabito J" first="J. M." last="Murabito">J. M. Murabito</name><affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Department of Medicine, Boston University School of Medicine</s1><s2>Boston, MA</s2><s3>USA</s3><sZ>15 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Boston, MA</wicri:noRegion></affiliation></author><author><name sortKey="Norman, P E" sort="Norman, P E" uniqKey="Norman P" first="P. E." last="Norman">P. E. Norman</name><affiliation wicri:level="1"><inist:fA14 i1="12"><s1>School of Surgery, University of Western Australia</s1><s2>Perth</s2><s3>AUS</s3><sZ>16 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Perth</wicri:noRegion></affiliation></author><author><name sortKey="Masaki, K H" sort="Masaki, K H" uniqKey="Masaki K" first="K. H." last="Masaki">K. H. Masaki</name><affiliation wicri:level="1"><inist:fA14 i1="13"><s1>Department of Geriatric Medicine, John A Burns School of Medicine, University of Hawaii</s1><s2>Honolulu,HI</s2><s3>USA</s3><sZ>17 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Honolulu,HI</wicri:noRegion></affiliation></author><author><name sortKey="Bouter, L M" sort="Bouter, L M" uniqKey="Bouter L" first="L. M." last="Bouter">L. M. Bouter</name><affiliation wicri:level="3"><inist:fA14 i1="14"><s1>Executive Board, VU University Amsterdam</s1><s2>Amsterdam</s2><s3>NLD</s3><sZ>18 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName></affiliation></author><author><name sortKey="Heine, R J" sort="Heine, R J" uniqKey="Heine R" first="R. J." last="Heine">R. J. Heine</name><affiliation wicri:level="3"><inist:fA14 i1="15"><s1>Diabetes Center, VU University Medical Center</s1><s2>Amsterdam</s2><s3>NLD</s3><sZ>19 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName></affiliation></author><author><name sortKey="Stehouwer, C D A" sort="Stehouwer, C D A" uniqKey="Stehouwer C" first="C. D. A." last="Stehouwer">C. D. A. Stehouwer</name><affiliation wicri:level="1"><inist:fA14 i1="16"><s1>Department of Internal Medicine, Maastricht University Medical Centre</s1><s2>Maastricht</s2><s3>NLD</s3><sZ>20 aut.</sZ></inist:fA14><country>Pays-Bas</country><wicri:noRegion>Maastricht</wicri:noRegion></affiliation></author><author><name sortKey="Mcdermott, M M" sort="Mcdermott, M M" uniqKey="Mcdermott M" first="M. M." last="Mcdermott">M. M. Mcdermott</name><affiliation wicri:level="1"><inist:fA14 i1="17"><s1>Department of Medicine, Northwestern University Feinberg School of Medicine</s1><s2>Chicago, IL</s2><s3>USA</s3><sZ>21 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Chicago, IL</wicri:noRegion></affiliation></author><author><name sortKey="Stoffers, H E J H" sort="Stoffers, H E J H" uniqKey="Stoffers H" first="H. E. J. H" last="Stoffers">H. E. J. H. Stoffers</name><affiliation wicri:level="1"><inist:fA14 i1="18"><s1>Department of General Practice/Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre</s1><s2>Maastricht</s2><s3>NLD</s3><sZ>22 aut.</sZ><sZ>23 aut.</sZ></inist:fA14><country>Pays-Bas</country><wicri:noRegion>Maastricht</wicri:noRegion></affiliation></author><author><name sortKey="Knottnerus, J A" sort="Knottnerus, J A" uniqKey="Knottnerus J" first="J. A." last="Knottnerus">J. A. Knottnerus</name><affiliation wicri:level="1"><inist:fA14 i1="18"><s1>Department of General Practice/Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre</s1><s2>Maastricht</s2><s3>NLD</s3><sZ>22 aut.</sZ><sZ>23 aut.</sZ></inist:fA14><country>Pays-Bas</country><wicri:noRegion>Maastricht</wicri:noRegion></affiliation></author><author><name sortKey="Ogren, M" sort="Ogren, M" uniqKey="Ogren M" first="M." last="Ogren">M. Ogren</name><affiliation wicri:level="4"><inist:fA14 i1="19"><s1>Department of Surgical Sciences (Vascular Surgery), Uppsala University</s1><s2>Uppsala</s2><s3>SWE</s3><sZ>24 aut.</sZ></inist:fA14><country>Suède</country><placeName><settlement type="city">Uppsala</settlement><region nuts="1">Svealand</region><region nuts="1">East Middle Sweden</region></placeName><orgName type="university">Université d'Uppsala</orgName></affiliation></author><author><name sortKey="Hedblad, B" sort="Hedblad, B" uniqKey="Hedblad B" first="B." last="Hedblad">B. Hedblad</name><affiliation wicri:level="1"><inist:fA14 i1="20"><s1>Department of Clinical Sciences, Skane University Hospital, Lund University</s1><s2>Malmo</s2><s3>SWE</s3><sZ>25 aut.</sZ></inist:fA14><country>Suède</country><wicri:noRegion>Malmo</wicri:noRegion></affiliation></author><author><name sortKey="Koenig, W" sort="Koenig, W" uniqKey="Koenig W" first="W." last="Koenig">W. Koenig</name><affiliation wicri:level="3"><inist:fA14 i1="21"><s1>Department of Internal Medicine II - Cardiology, University of Ulm Medical Center</s1><s2>Ulm</s2><s3>DEU</s3><sZ>26 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Tübingen</region><settlement type="city">Ulm</settlement></placeName></affiliation></author><author><name sortKey="Meisinger, C" sort="Meisinger, C" uniqKey="Meisinger C" first="C." last="Meisinger">C. Meisinger</name><affiliation wicri:level="1"><inist:fA14 i1="22"><s1>Institute of Epidemiology II, Helmholtz Zentrum Munchen</s1><s2>Neuherberg</s2><s3>DEU</s3><sZ>27 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Neuherberg</wicri:noRegion><wicri:noRegion>Helmholtz Zentrum Munchen</wicri:noRegion><wicri:noRegion>Neuherberg</wicri:noRegion></affiliation></author><author><name sortKey="Cauley, J A" sort="Cauley, J A" uniqKey="Cauley J" first="J. A." last="Cauley">J. A. Cauley</name><affiliation wicri:level="4"><inist:fA14 i1="07"><s1>Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh</s1><s2>Pittsburgh, PA</s2><s3>USA</s3><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>28 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Pittsburgh</settlement><region type="state">Pennsylvanie</region></placeName><orgName type="university">Université de Pittsburgh</orgName></affiliation></author><author><name sortKey="Franco, O H" sort="Franco, O H" uniqKey="Franco O" first="O. H." last="Franco">O. H. Franco</name><affiliation wicri:level="3"><inist:fA14 i1="23"><s1>Department of Epidemiology, Erasmus MC</s1><s2>Rotterdam</s2><s3>NLD</s3><sZ>29 aut.</sZ><sZ>30 aut.</sZ><sZ>31 aut.</sZ><sZ>32 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Hunink, M G M" sort="Hunink, M G M" uniqKey="Hunink M" first="M. G. M." last="Hunink">M. G. M. Hunink</name><affiliation wicri:level="3"><inist:fA14 i1="23"><s1>Department of Epidemiology, Erasmus MC</s1><s2>Rotterdam</s2><s3>NLD</s3><sZ>29 aut.</sZ><sZ>30 aut.</sZ><sZ>31 aut.</sZ><sZ>32 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Hofman, A" sort="Hofman, A" uniqKey="Hofman A" first="A." last="Hofman">A. Hofman</name><affiliation wicri:level="3"><inist:fA14 i1="23"><s1>Department of Epidemiology, Erasmus MC</s1><s2>Rotterdam</s2><s3>NLD</s3><sZ>29 aut.</sZ><sZ>30 aut.</sZ><sZ>31 aut.</sZ><sZ>32 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Witteman, J C" sort="Witteman, J C" uniqKey="Witteman J" first="J. C." last="Witteman">J. C. Witteman</name><affiliation wicri:level="3"><inist:fA14 i1="23"><s1>Department of Epidemiology, Erasmus MC</s1><s2>Rotterdam</s2><s3>NLD</s3><sZ>29 aut.</sZ><sZ>30 aut.</sZ><sZ>31 aut.</sZ><sZ>32 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Criqui, M H" sort="Criqui, M H" uniqKey="Criqui M" first="M. H." last="Criqui">M. H. Criqui</name><affiliation wicri:level="1"><inist:fA14 i1="24"><s1>Department of Family and Preventive Medicine, University of California San Diego</s1><s2>La Jolla, CA</s2><s3>USA</s3><sZ>33 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>La Jolla, CA</wicri:noRegion></affiliation></author><author><name sortKey="Langer, R D" sort="Langer, R D" uniqKey="Langer R" first="R. D." last="Langer">R. D. Langer</name><affiliation wicri:level="1"><inist:fA14 i1="25"><s1>Department of Family Medicine - Las Vegas, University of Nevada School of Medicine</s1><s2>Las Vegas, NV</s2><s3>USA</s3><sZ>34 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Las Vegas, NV</wicri:noRegion></affiliation></author><author><name sortKey="Hiatt, W R" sort="Hiatt, W R" uniqKey="Hiatt W" first="W. R." last="Hiatt">W. R. Hiatt</name></author><author><name sortKey="Hamman, R F" sort="Hamman, R F" uniqKey="Hamman R" first="R. F." last="Hamman">R. F. Hamman</name></author></analytic><series><title level="j" type="main">European journal of preventive cardiology : (Print)</title><idno type="ISSN">2047-4873</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">European journal of preventive cardiology : (Print)</title><idno type="ISSN">2047-4873</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Ankle Brachial pressure Index</term><term>Arterial pressure</term><term>Cardiovascular disease</term><term>Development</term><term>Models</term><term>Prediction</term><term>Predictive factor</term><term>Prevention</term><term>Risk</term><term>Risk factor</term><term>Test validation</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Développement</term><term>Validation test</term><term>Indice de pression cheville bras</term><term>Pression artérielle</term><term>Facteur risque</term><term>Risque</term><term>Modèle</term><term>Prédiction</term><term>Facteur prédictif</term><term>Pathologie de l'appareil circulatoire</term><term>Prévention</term><term>Maladie cardiovasculaire</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background: The ankle brachial index (ABI) is related to risk of cardiovascular events independent of the Framingham risk score (FRS). The aim of this study was to develop and evaluate a risk model for cardiovascular events incorporating the ABI and FRS. Design: An analysis of participant data from 18 cohorts in which 24,375 men and 20,377 women free of coronary heart disease had ABI measured and were followed up for events. Methods: Subjects were divided into a development and internal validation dataset and an external validation dataset. Two models, comprising FRS and FRS + ABI, were fitted for the primary outcome of major coronary events. Results: In predicting events in the external validation dataset, C-index for the FRS was 0.672 (95% CI 0.599 to 0.737) in men and 0.578 (95% CI 0.492 to 0.661) in women. The FRS + ABI led to a small increase in C-index in men to 0.685 (95% CI 0.612 to 0.749) and large increase in women to 0.690 (95% CI 0.605 to 0.764) with net reclassification improvement (NRI) of 4.3% (95% CI 0.0 to 7.6%, p=0.050) and 9.6% (95% CI 6.1 to 16.4%, p <0.001), respectively. Restricting the FRS + ABI model to those with FRS intermediate 10-year risk of 10 to 19% resulted in higher NRI of 15.9% (95% CI 6.1 to 20.6%, p < 0.001) in men and 23.3% (95% CI 13.8 to 62.5%, p = 0.002) in women. However, incorporating ABI in an improved newly fitted risk factor model had a nonsignificant effect: NRI 2.0% (95% CI 2.3 to 4.2%, p=0.567) in men and 1.1% (95% CI 1.9 to 4.0%, p=0.483) in women.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>Belgique</li><li>Pays-Bas</li><li>Royaume-Uni</li><li>Suède</li><li>États-Unis</li></country><region><li>Bade-Wurtemberg</li><li>District de Tübingen</li><li>East Middle Sweden</li><li>Hollande-Méridionale</li><li>Hollande-Septentrionale</li><li>Pennsylvanie</li><li>Province de Flandre-Orientale</li><li>Région de Bruxelles-Capitale</li><li>Région flamande</li><li>Svealand</li><li>Écosse</li></region><settlement><li>Amsterdam</li><li>Bruxelles</li><li>Gand</li><li>Pittsburgh</li><li>Rotterdam</li><li>Ulm</li><li>Uppsala</li><li>Édimbourg</li></settlement><orgName><li>Université d'Uppsala</li><li>Université d'Édimbourg</li><li>Université de Gand</li><li>Université de Pittsburgh</li><li>Université libre de Bruxelles</li></orgName></list><tree><noCountry><name sortKey="Hamman, R F" sort="Hamman, R F" uniqKey="Hamman R" first="R. F." last="Hamman">R. F. Hamman</name><name sortKey="Hiatt, W R" sort="Hiatt, W R" uniqKey="Hiatt W" first="W. R." last="Hiatt">W. R. Hiatt</name></noCountry><country name="Royaume-Uni"><region name="Écosse"><name sortKey="Fowkes, F G R" sort="Fowkes, F G R" uniqKey="Fowkes F" first="F. G. R." last="Fowkes">F. G. R. Fowkes</name></region><name sortKey="Butcher, I" sort="Butcher, I" uniqKey="Butcher I" first="I." last="Butcher">I. Butcher</name><name sortKey="Lee, A J" sort="Lee, A J" uniqKey="Lee A" first="A. J." last="Lee">A. J. Lee</name><name sortKey="Murray, G D" sort="Murray, G D" uniqKey="Murray G" first="G. D." last="Murray">G. D. Murray</name><name sortKey="Price, J F" sort="Price, J F" uniqKey="Price J" first="J. F." last="Price">J. F. Price</name></country><country name="États-Unis"><noRegion><name sortKey="Folsom, A R" sort="Folsom, A R" uniqKey="Folsom A" first="A. R." last="Folsom">A. R. Folsom</name></noRegion><name sortKey="Cauley, J A" sort="Cauley, J A" uniqKey="Cauley J" first="J. A." last="Cauley">J. A. Cauley</name><name sortKey="Couper, D J" sort="Couper, D J" uniqKey="Couper D" first="D. J." last="Couper">D. J. Couper</name><name sortKey="Criqui, M H" sort="Criqui, M H" uniqKey="Criqui M" first="M. H." last="Criqui">M. H. Criqui</name><name sortKey="Cushman, M" sort="Cushman, M" uniqKey="Cushman M" first="M." last="Cushman">M. Cushman</name><name sortKey="D Agostino, R B Sr" sort="D Agostino, R B Sr" uniqKey="D Agostino R" first="R. B. Sr" last="D'Agostino">R. B. Sr D'Agostino</name><name sortKey="Hirsch, A T" sort="Hirsch, A T" uniqKey="Hirsch A" first="A. T." last="Hirsch">A. T. Hirsch</name><name sortKey="Langer, R D" sort="Langer, R D" uniqKey="Langer R" first="R. D." last="Langer">R. D. Langer</name><name sortKey="Masaki, K H" sort="Masaki, K H" uniqKey="Masaki K" first="K. H." last="Masaki">K. H. Masaki</name><name sortKey="Mcdermott, M M" sort="Mcdermott, M M" uniqKey="Mcdermott M" first="M. M." last="Mcdermott">M. M. Mcdermott</name><name sortKey="Murabito, J M" sort="Murabito, J M" uniqKey="Murabito J" first="J. M." last="Murabito">J. M. Murabito</name><name sortKey="Newman, A B" sort="Newman, A B" uniqKey="Newman A" first="A. B." last="Newman">A. B. Newman</name><name sortKey="Sutton Tyrrell, K C" sort="Sutton Tyrrell, K C" uniqKey="Sutton Tyrrell K" first="K. C." last="Sutton-Tyrrell">K. C. Sutton-Tyrrell</name></country><country name="Belgique"><region name="Région flamande"><name sortKey="Debacker, G" sort="Debacker, G" uniqKey="Debacker G" first="G." last="Debacker">G. Debacker</name></region><name sortKey="Kornitzer, M" sort="Kornitzer, M" uniqKey="Kornitzer M" first="M." last="Kornitzer">M. Kornitzer</name></country><country name="Australie"><noRegion><name sortKey="Norman, P E" sort="Norman, P E" uniqKey="Norman P" first="P. E." last="Norman">P. E. Norman</name></noRegion></country><country name="Pays-Bas"><region name="Hollande-Septentrionale"><name sortKey="Bouter, L M" sort="Bouter, L M" uniqKey="Bouter L" first="L. M." last="Bouter">L. M. Bouter</name></region><name sortKey="Franco, O H" sort="Franco, O H" uniqKey="Franco O" first="O. H." last="Franco">O. H. Franco</name><name sortKey="Heine, R J" sort="Heine, R J" uniqKey="Heine R" first="R. J." last="Heine">R. J. Heine</name><name sortKey="Hofman, A" sort="Hofman, A" uniqKey="Hofman A" first="A." last="Hofman">A. Hofman</name><name sortKey="Hunink, M G M" sort="Hunink, M G M" uniqKey="Hunink M" first="M. G. M." last="Hunink">M. G. M. Hunink</name><name sortKey="Knottnerus, J A" sort="Knottnerus, J A" uniqKey="Knottnerus J" first="J. A." last="Knottnerus">J. A. Knottnerus</name><name sortKey="Stehouwer, C D A" sort="Stehouwer, C D A" uniqKey="Stehouwer C" first="C. D. A." last="Stehouwer">C. D. A. Stehouwer</name><name sortKey="Stoffers, H E J H" sort="Stoffers, H E J H" uniqKey="Stoffers H" first="H. E. J. H" last="Stoffers">H. E. J. H. Stoffers</name><name sortKey="Witteman, J C" sort="Witteman, J C" uniqKey="Witteman J" first="J. C." last="Witteman">J. C. Witteman</name></country><country name="Suède"><region name="Svealand"><name sortKey="Ogren, M" sort="Ogren, M" uniqKey="Ogren M" first="M." last="Ogren">M. Ogren</name></region><name sortKey="Hedblad, B" sort="Hedblad, B" uniqKey="Hedblad B" first="B." last="Hedblad">B. Hedblad</name></country><country name="Allemagne"><region name="Bade-Wurtemberg"><name sortKey="Koenig, W" sort="Koenig, W" uniqKey="Koenig W" first="W." last="Koenig">W. Koenig</name></region><name sortKey="Meisinger, C" sort="Meisinger, C" uniqKey="Meisinger C" first="C." last="Meisinger">C. Meisinger</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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