Evidence map›Paper›PMID 40932135›Full record

ArticleJournal of the American Heart Association2025

Validation of the American Heart Association Predicting Risk of Cardiovascular Disease Events Equations in Diverse Socioeconomic Groups: The All of Us Cohort.

Ashley Adanna Lewis, Adrian Matias Bacong, Latha Palaniappan, Tina Hernandez-Boussard

Abstract readValidation Study
In one paragraph

Article in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Ashley Adanna LewisDepartment of Biomedical Data Science Stanford University Stanford CA USA.ORCID 0000-0003-3062-9849
Adrian Matias BacongDepartment of Medicine, Division of Cardiovascular Medicine Stanford University School of Medicine Palo Alto CA USA.ORCID 0000-0003-0157-4754
Latha PalaniappanDepartment of Medicine, Division of Cardiovascular Medicine Stanford University School of Medicine Palo Alto CA USA.ORCID 0000-0002-1245-665X
Tina Hernandez-BoussardDepartment of Biomedical Data Science Stanford University Stanford CA USA.ORCID 0000-0001-6553-3455

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn 2023, the American Heart Association PREVENT (Predicting Risk of Cardiovascular Disease Events) equations were introduced as a tool to improve cardiovascular disease (CVD) risk prediction. This study tests their performance in a diverse socioeconomic cohort.

methodsWe analyzed All of Us participants aged 30 to 79 years without baseline CVD who had required PREVENT input data over a 5.4-year follow-up. Discrimination was assessed using Harrell's C-statistic, with calibration by comparing predicted and observed 5-year CVD rates across 10-year risk deciles. Mean data are ±SD.

resultsWe examined 9010 individuals (mean age, 63.0±11.0 years; 45.5% male). Racial and ethnic composition was 61.7% non-Hispanic White, 17.2% non-Hispanic Black, 4.5% multiracial/other, 1.3% non-Hispanic Asian, and 11.2% Hispanic or Latino. The "other" race/ethnic category reflects participants who self-identified as "other" in response to the, "Which category describes you?" item in the Basics survey. Over a mean follow-up of 3.6±1.8 years, 9.0% experienced a cardiovascular event. The mean 10-year predicted risks were 0.23±0.17 for total CVD, 0.13±0.10 for atherosclerotic CVD (ASCVD), and 0.19±0.17 for heart failure. The predicted-to-observed rate ratios were 5.3 for CVD and 3.3 for ASCVD. The C statistic for the overall sample was 0.732 (95% CI, 0.718-0.752) for CVD, 0.716 (95% CI, 0.698-0.741) for ASCVD, and 0.777 (95% CI, 0.757-0.800) for heart failure.

conclusionsThe PREVENT equations showed strong discrimination across all strata in this national cohort. Overprediction of CVD events likely reflects baseline differences in comorbidity burden between the PREVENT development cohort and this All of Us cohort, particularly due to the exclusion of individuals missing estimated glomerular filtration rate, a variable not routinely collected and likely missing, not at random. Strong discrimination supports potential clinical utility, though further work is needed to improve calibration in this population.

Indexed as

American Heart AssociationCardiovascular DiseasesAdultAgedFemaleHeart Disease Risk FactorsHumansMaleMiddle AgedPredictive Value of TestsReproducibility of ResultsRisk AssessmentRisk FactorsSocioeconomic FactorsUnited Statescardiovascular diseasecardiovascular modelsheart failurerisk predictionsocial determinants of health

Identifiers

PMID40932135
PMCPMC12554416

What Socratic holds

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LicenceCC BY-NC
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Registered trials

None linked

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 Socratic graph.