TY - JOUR
T1 - Validation of the ARIC prediction model for sudden cardiac death in the European population
T2 - The ESCAPE-NET project
AU - Welten, Sabrina J. G. C.
AU - Remmelzwaal, Sharon
AU - Blom, Marieke T.
AU - van der Heijden, Amber A.
AU - Nijpels, Giel
AU - Tan, Hanno L.
AU - van Valkengoed, Irene
AU - Empana, Jean-Philippe
AU - Jouven, Xavier
AU - Ågesen, Frederik Nybye
AU - Warming, Peder Emil
AU - Tfelt-Hansen, Jacob
AU - for ESCAPE-NET investigators
AU - Prescott, Eva
AU - Jabbari, Reza
AU - Elders, Petra J. M.
N1 - Funding Information: This work was supported by the European Union's Horizon 2020 research and innovation program ESCAPE-NET [grant number 733381 ] and the COST Action PARQ (grant agreement No CA19137 ) supported by COST (European Cooperation in Science and Technology). Publisher Copyright: © 2023 The Author(s)
PY - 2023/8/1
Y1 - 2023/8/1
N2 - Background: Sudden cardiac death is responsible for 10% to 20% of all deaths in Europe. The current study investigates how well the risk of sudden cardiac death can be predicted. To this end, we validated a previously developed prediction model for sudden cardiac death from the Atherosclerosis Risk in Communities study (USA). Methods: Data from participants of the Copenhagen City Heart Study (CCHS) (n=9988) was used to externally validate the previously developed prediction model for sudden cardiac death. The model's performance was assessed through discrimination (C-statistic) and calibration by the Hosmer-Lemeshow goodness-of-fit (HL) statistics suited for censored data and visual inspection of calibration plots. Additional validation was performed using data from the Hoorn Study (N=2045), employing the same methods. Results: During ten years of follow-up of CCHS participants (mean age: 58.7 years, 56.2% women), 425 experienced SCD (4.2%). The prediction model showed good discrimination for sudden cardiac death risk (C-statistic: 0.81, 95% CI: 0.79-0.83). Calibration was robust (HL statistic: P=0.8). Visual inspection of the calibration plot showed that the calibration could be improved. Sensitivity was 89.8%, and specificity was 60.6%. The positive and negative predictive values were 10.1% and 99.2%. Model performance was similar in the Hoorn Study (C-statistic: 0.81, 95% CI: 0.77-0.85 and the HL statistic: 1.00). Conclusion: Our study showed that the previously developed prediction model in North American adults performs equally well in identifying those at risk for sudden cardiac death in a general North-West European population. However, the positive predictive value is low.
AB - Background: Sudden cardiac death is responsible for 10% to 20% of all deaths in Europe. The current study investigates how well the risk of sudden cardiac death can be predicted. To this end, we validated a previously developed prediction model for sudden cardiac death from the Atherosclerosis Risk in Communities study (USA). Methods: Data from participants of the Copenhagen City Heart Study (CCHS) (n=9988) was used to externally validate the previously developed prediction model for sudden cardiac death. The model's performance was assessed through discrimination (C-statistic) and calibration by the Hosmer-Lemeshow goodness-of-fit (HL) statistics suited for censored data and visual inspection of calibration plots. Additional validation was performed using data from the Hoorn Study (N=2045), employing the same methods. Results: During ten years of follow-up of CCHS participants (mean age: 58.7 years, 56.2% women), 425 experienced SCD (4.2%). The prediction model showed good discrimination for sudden cardiac death risk (C-statistic: 0.81, 95% CI: 0.79-0.83). Calibration was robust (HL statistic: P=0.8). Visual inspection of the calibration plot showed that the calibration could be improved. Sensitivity was 89.8%, and specificity was 60.6%. The positive and negative predictive values were 10.1% and 99.2%. Model performance was similar in the Hoorn Study (C-statistic: 0.81, 95% CI: 0.77-0.85 and the HL statistic: 1.00). Conclusion: Our study showed that the previously developed prediction model in North American adults performs equally well in identifying those at risk for sudden cardiac death in a general North-West European population. However, the positive predictive value is low.
UR - http://www.scopus.com/inward/record.url?scp=85159094819&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.ahj.2023.03.018
DO - https://doi.org/10.1016/j.ahj.2023.03.018
M3 - Article
C2 - 37084935
SN - 0002-8703
VL - 262
SP - 55
EP - 65
JO - American Heart Journal
JF - American Heart Journal
ER -