ArticleAnnals of internal medicine2015
An analysis of calibration and discrimination among multiple cardiovascular risk scores in a modern multiethnic cohort.
Article in Annals of internal medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 244 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
244 citing papers in PubMed, 5 syntheses or guidelines pooled it, 512 citations in OpenAlex.
- Pooled it
- 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.Journal of the American College of Cardiology · 2019Guideline
- Performance of the Framingham risk models and pooled cohort equations for predicting 10-year risk of cardiovascular disease: a systematic review and meta-analysis.BMC medicine · 2019Pooled it
- Equalization of four cardiovascular risk algorithms after systematic recalibration: individual-participant meta-analysis of 86 prospective studies.European heart journal · 2019Pooled it
- An Appraisal of Biomarker-Based Risk-Scoring Models in Chronic Heart Failure: Which One Is Best?Current heart failure reports · 2018Pooled it
- Using PREVENT Equations to Compare Intensive vs Standard Systolic Blood Pressure Control for Primary Prevention in SPRINT.Journal of the American College of Cardiology · 2025Trial
- Risk Assessment in Patients With Diabetes With the TIMI Risk Score for Atherothrombotic Disease.Diabetes care · 2018Trial
- Real-world impact of coronary artery calcium scoring on primary prevention management in a community cardiology practice.American heart journal plus : cardiology research and practice · 2026Article
- Comparison of ASCVD Risk Prediction Models in STEMI: Insights From a South Asian Cohort.JACC. Asia · 2026Article
- Review
- Performance of cardiovascular disease risk prediction tools in chronic obstructive pulmonary disease.Annals of the American Thoracic Society · 2026Article
- Beyond SCORE2: Rethinking Cardiovascular Risk Assessment in a Very-High-Risk European Setting-A Narrative Review and Proposal of the ROMA-CV Algorithm for Romania.Journal of clinical medicine · 2026Review
- Recalibration and external validation of vascular risk calculators for multiple sclerosis: A population-based study using CPRD data in England, 1987-2023.Multiple sclerosis (Houndmills, Basingstoke, England) · 2026Article
- Real-World Pharmacotherapy-Driven Cardiovascular Risk Prediction Using Interpretable Machine Learning and Jordanian EHR Data.Medical sciences (Basel, Switzerland) · 2026Article
- Clinically Relevant Discordance Between SCORE2 and REGICOR in Spanish Workers: Implications for Cardiovascular Risk Reclassification in Primary Prevention.Medical sciences (Basel, Switzerland) · 2026Article
- Zonal determinants of healthy aging: An exposomic analysis of determinants of healthy cardiovascular aging in Ohio.American journal of preventive cardiology · 2026Article
- Diagnostic Accuracy of Cardiovascular Disease Prediction Models: A Systematic Review and Meta-Analysis of Validation Studies.Health science reports · 2026Review
- Cardiovascular risk prediction in women with gestational diabetes using risk assessment tools: a scoping review.Diabetology & metabolic syndrome · 2026Article
- External validation and recalibration of cardiovascular risk scores for prediction of 10-year risk of fatal cardiovascular disease: a prospective, observational, population-based cohort analysis of adults in Mexico City.Lancet regional health. Americas · 2026Article
- Innovations In Artificial Intelligence-Guided Atherosclerosis Cardiovascular Imaging: From Detection to Prognosis.Current atherosclerosis reports · 2026Review
184 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundAccurate risk assessment of atherosclerotic cardiovascular disease (ASCVD) is essential to effectively balance the risks and benefits of therapy for primary prevention.
objectiveTo compare the calibration and discrimination of the new American Heart Association (AHA) and American College of Cardiology (ACC) ASCVD risk score with alternative risk scores and to explore preventive therapy as a cause of the reported risk overestimation using the AHA-ACC-ASCVD score.
designProspective epidemiologic study of ASCVD.
settingMESA (Multi-Ethnic Study of Atherosclerosis), a community-based, sex-balanced, multiethnic cohort. PATIENTS: 4227 MESA participants aged 50 to 74 years and without diabetes at baseline. MEASUREMENTS: Observed and expected events for the AHA-ACC-ASCVD score were compared with 4 commonly used risk scores-and their respective end points-in MESA after a 10.2-year follow-up.
resultsThe new AHA-ACC-ASCVD and 3 older Framingham-based risk scores overestimated cardiovascular events by 37% to 154% in men and 8% to 67% in women. Overestimation was noted throughout the continuum of risk. In contrast, the Reynolds Risk Score overestimated risk by 9% in men but underestimated risk by 21% in women. Aspirin, lipid-lowering or antihypertensive therapy, and interim revascularization did not explain the overestimation. LIMITATION: Comparability of MESA with target populations for primary prevention and possibility of missed events in MESA.
conclusionOf the 5 risk scores, 4, including the new AHA-ACC-ASCVD score, showed overestimation of risk (25% to 115%) in a modern, multiethnic cohort without baseline clinical ASCVD. If validated, overestimation of ASCVD risk may have substantial implications for individual patients and the health care system. PRIMARY FUNDING SOURCE: National Heart, Lung, and Blood Institute.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.