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Original article Prediction of the 10-year risk of atherosclerotic cardiovascular disease in the Korean population
Sangwoo Park1orcid , Yong-Giun Kim1orcid , Soe Hee Ann1orcid , Young-Rak Cho2orcid , Shin-Jae Kim1orcid , Seungbong Han3orcid , Gyung-Min Park1orcid
Epidemiol Health 2023;e2023052
DOI: https://doi.org/10.4178/epih.e2023052 [Accepted]
Published online: May 12, 2023
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1Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
2Department of cardiology, Dong-a university hospital, Busan, Korea
3Department of biostatistics, college of medicine, Korea university, Seoul, Korea
Corresponding author:  Seungbong Han,
Email: min8684@hanmail.net
Gyung-Min Park,
Email: min8684@hanmail.net
Received: 21 October 2022   • Revised: 20 April 2023   • Accepted: 21 April 2023

Proper risk assessment is important for the primary prevention of atherosclerotic cardiovascular disease (ASCVD). However, no validated risk prediction tools are currently in use in Korea. This study sought to develop a 10-year risk prediction model for incident ASCVD.
Using the National Sample Cohort of Korea, 325,934 subjects aged 20–80 years without previous ASCVD were enrolled. ASCVD was defined as a composite of cardiovascular death, myocardial infarction, and stroke. The Korean ASCVD risk prediction (K-CVD) model was developed separately for men and women using the development dataset and validated in the validation dataset. Furthermore, the model performance was compared with the Framingham Risk Score (FRS) and pooled cohort equation (PCE).
Over 10 years of follow-up, 4,367 ASCVD events occurred in the overall population. The predictors of ASCVD included in the model were age, smoking status, diabetes, systolic blood pressure, lipid profiles, urine protein, and lipid-lowering and blood pressure-lowering treatment. The K-CVD model had good discrimination and strong calibration in the validation dataset (time-dependent area under the curve=0.846; 95% CI, 0.828–0.864; calibration χ2=4.73, goodness-of-fit p=0.32). Compared with our model, both FRS and PCE showed worse calibration, overestimating ASCVD risk in the Korean population.
Through a nationwide cohort, we developed a model for 10-year ASCVD risk prediction in a contemporary Korean population. The K-CVD model showed excellent discrimination and calibration in Koreans. This population-based risk prediction tool would help to appropriately identify high-risk individuals and provide preventive interventions in the Korean population.

Epidemiol Health : Epidemiology and Health