An external validation of Thais’ cardiovascular 10-year risk assessment in the southern Thailand
DOI:
https://doi.org/10.14456/reg11med.2022.16Keywords:
An external validation, Cardiovascular diseases, Cardiovascular events, CV risk model, Thai CV risk scoreAbstract
Background: Cardiovascular diseases (CVDs) are the number one cause of death globally. WHO estimated that CVD was a cause of 17.9 million deaths (or 31% of all global deaths) in 2019. It may seem surprising, but we can easily prevent CVDs by altering our lifestyles to avoid associated risk factors. The only requirement needed is to know one's risk apriori. Various versions of cardiovascular risk scores are adopted to assess cardiovascular risk and associated risk factors in many countries. Thailand developed as the Thai CV risk score as a reliable tool to forecast the risk of having a cardiovascular event in the future for Thais.
Objective: This study is an external validation of the Thai CV risk score. We aim to answer two key questions. Firstly, Can the Thai CV Risk score developed using the dataset of people from the central and northwestern regions of Thailand applies to people from other parts of the country? Secondly, Can the Thai CV Risk score, developed for general people, work for hospital patients who tend to have a higher risk?
Method: This work is a retrospective study set out to answer two questions using a dataset of 1,025 patients from Lansaka Hospital in southern Thailand. We calculated 10-years cardiovascular risk using the following factors – sex, age, smoke, diabetes, systolic blood pressure, LDL, and HDL -- of all patients in 2008 and compare the predictive result to observe their actual cardiovascular events from 2008 to 2017.
Result: We are able to find answers to both questions in this study. We find that the Thai CV risk score works for the southern Thais population, including patients in the hospital. It generally works well for the low CV risk group.
Conclusion: Even though the Thai CV risk score is applicable for hospital settings, it tends to overestimate moderate and high risks. Fortunately, this poses no serious concern for general people as it only makes people more careful about their lifestyle. The doctor should be careful when using the score with other factors to make a treatment decision.
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