Primary prevention cardiovascular disease risk prediction model for contemporary Chinese (1°P-CARDIAC): Model derivation and validation using a hybrid statistical and machine-learning approach

作者：Yekai Zhou, Celia Jiaxi Lin, Qiuyan Yu, Joseph E. Blais, Eric Yuk Fai Wan, Chun‐Ka Wong, Kathryn Tan, David Chung-Wah Siu, Kai Hang Yiu, Esther W. Chan, Doris Sau Fung Yu, William Chi Wai Wong, Tak‐Wah Lam, Ian Chi Kei Wong, Ruibang Luo, Celine Sze Ling Chui · 发表于：PLoS ONE · 年份：2025 · DOI：10.1371/journal.pone.0322419 · 被引用次数：2 · 研究领域：Lipoproteins and Cardiovascular Health、Cardiovascular Health and Risk Factors、Acute Myocardial Infarction Research

BACKGROUND: Cardiovascular disease (CVD) is the leading cause of mortality and morbidity in China and worldwide while we are lacking in validated primary prevention model specifically for Chinese. To identify CVD high-risk individuals for early intervention, we created and validated a primary prevention risk prediction model, Personalized CARdiovascular DIsease risk Assessment for Chinese (1°P-CARDIAC), in contemporary Chinese cohorts in Hong Kong. METHODS: Patients without any history of CVD was categorized as derivation and validation cohorts based on their different geographical location of residence in Hong Kong. The outcome was the first diagnosis of a composite of coronary heart disease, ischemic or hemorrhagic stroke, peripheral artery disease, and revascularization. The full model incorporated all available variables in the dataset as clinical laboratory tests, disease and medication history, family history of disease, demographic factors, and healthcare utilization. We employed XGBoost Cox model and multivariate imputation with chained equation (MICE) for derivation and missing data replacement. A basic model was developed with the integration of statistically significant and important subset of risk variables by least absolute shrinkage and selection operator (LASSO) regression. Validation was performed by 1000 bootstrap replicates and compared to four existing models: PREDICT, pooled cohort equation (PCE), China-PAR, and Framingham (Asian). RESULTS: The study inclu...