Observed and predicted atherosclerotic cardiovascular disease (ASCVD) risks among women were better aligned after including ASCVD events from the Centers for Medicare and Medicaid Services (CMS) claims, a recent study found. Researchers evaluated the predictive accuracy of the Pooled Cohort Equations (PCE) in the Women’s Health Initiative (WHI), a multiethnic cohort of contemporary postmenopausal women. They evaluated the effects of time-varying treatments such as aspirin and statins, and ascertainment of additional ASCVD events by linkage with CMS claims. They found:
- 19,995 women (mean age 64 years; 41.5% white, 38.5% black, 17.5% Hispanic, 0.5% American Indian, 1.6% Asian/Pacific Islander, and 0.4% unknown).
- Observed ASCVD risks were generally lower than predicted by PCE with adjustment for changes in statin and aspirin use resulting in small increased in observed risks.
- WHI-adjusted risks were also lower than predicted but observed (predicted) risks became aligned after including events ascertained by linkage with CMS for additional surveillance for events.
- Similar results were seen across ethnic/racial groups.
Mora S, Wenger NK, Cook NR, et al. Evaluation of the pooled cohort risk equations for cardiovascular risk prediction in a multiethnic cohort from the Women’s Health Initiative. [Published online ahead of print July 23, 2018]. JAMA Intern Med. doi:10.1001/jamainternmed.2018.2875.