title: Model for assessing cardiovascular risk in a Korean population.
abstract: BACKGROUND
  A model for predicting cardiovascular disease in Asian populations is limited.
  
  
  RESULTS
  In total, 57 393 consecutive asymptomatic Korean individuals aged 30 to 80 years without a prior history of cardiovascular disease who underwent a general health examination were enrolled. Subjects were randomly classified into the train (n=45 914) and validation (n=11 479) cohorts. Thirty-one possible risk factors were assessed. The cardiovascular event was a composite of cardiovascular death, myocardial infarction, and stroke. In the train cohort, the C-index (95% confidence interval) and Akaike Information Criterion were used to develop the best-fitting prediction model. In the validation cohort, the predicted versus the observed cardiovascular event rates were compared by the C-index and Nam and D'Agostino χ(2) statistics. During a median follow-up period of 3.1 (interquartile range, 1.9-4.3) years, 458 subjects had 474 cardiovascular events. In the train cohort, the best-fitting model consisted of age, diabetes mellitus, hypertension, current smoking, family history of coronary heart disease, white blood cell, creatinine, glycohemoglobin, atrial fibrillation, blood pressure, and cholesterol (C-index =0.757 [0.726-0.788] and Akaike Information Criterion =7207). When this model was tested in the validation cohort, it performed well in terms of discrimination and calibration abilities (C-index=0.760 [0.693-0.828] and Nam and D'Agostino χ(2) statistic =0.001 for 3 years; C-index=0.782 [0.719-0.846] and Nam and D'Agostino χ(2) statistic=1.037 for 5 years).
  
  
  CONCLUSIONS
  A risk model based on traditional clinical and biomarkers has a feasible model performance in predicting cardiovascular events in an asymptomatic Korean population.
authors.affiliation: From the Department of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea (G.-M.P., S.H.H.); Departments of Biostatistics (S.H., J.B.L., M.S.L.), Preventive Medicine (M.-W.J.), Cardiology, (J.-M.A., S.-W.L., Y.-H.K., S.-W.P., S,-J.P.), Endocrinology and Metabolism (B.-J.K., J.-M.K.), and Health Screening and Promotion Center (H.-K.K., J.C.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Department of Nursing, College of Medicine, Dankook University, Cheonan, Korea (S.H.K.); Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea (H.C.K.); and Research and Development Center, Health Insurance Review and Assessment Service, Seoul, Korea (H.C.K.).
authors.forename: Gyung-Min
authors.initials: GM
authors.lastname: Park
authors.affiliation: From the Department of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea (G.-M.P., S.H.H.); Departments of Biostatistics (S.H., J.B.L., M.S.L.), Preventive Medicine (M.-W.J.), Cardiology, (J.-M.A., S.-W.L., Y.-H.K., S.-W.P., S,-J.P.), Endocrinology and Metabolism (B.-J.K., J.-M.K.), and Health Screening and Promotion Center (H.-K.K., J.C.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Department of Nursing, College of Medicine, Dankook University, Cheonan, Korea (S.H.K.); Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea (H.C.K.); and Research and Development Center, Health Insurance Review and Assessment Service, Seoul, Korea (H.C.K.).
authors.forename: Seungbong
authors.initials: S
authors.lastname: Han
authors.affiliation: From the Department of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea (G.-M.P., S.H.H.); Departments of Biostatistics (S.H., J.B.L., M.S.L.), Preventive Medicine (M.-W.J.), Cardiology, (J.-M.A., S.-W.L., Y.-H.K., S.-W.P., S,-J.P.), Endocrinology and Metabolism (B.-J.K., J.-M.K.), and Health Screening and Promotion Center (H.-K.K., J.C.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Department of Nursing, College of Medicine, Dankook University, Cheonan, Korea (S.H.K.); Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea (H.C.K.); and Research and Development Center, Health Insurance Review and Assessment Service, Seoul, Korea (H.C.K.).
authors.forename: Seon Ha
authors.initials: SH
authors.lastname: Kim
authors.affiliation: From the Department of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea (G.-M.P., S.H.H.); Departments of Biostatistics (S.H., J.B.L., M.S.L.), Preventive Medicine (M.-W.J.), Cardiology, (J.-M.A., S.-W.L., Y.-H.K., S.-W.P., S,-J.P.), Endocrinology and Metabolism (B.-J.K., J.-M.K.), and Health Screening and Promotion Center (H.-K.K., J.C.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Department of Nursing, College of Medicine, Dankook University, Cheonan, Korea (S.H.K.); Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea (H.C.K.); and Research and Development Center, Health Insurance Review and Assessment Service, Seoul, Korea (H.C.K.).
authors.forename: Min-Woo
authors.initials: MW
authors.lastname: Jo
authors.affiliation: From the Department of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea (G.-M.P., S.H.H.); Departments of Biostatistics (S.H., J.B.L., M.S.L.), Preventive Medicine (M.-W.J.), Cardiology, (J.-M.A., S.-W.L., Y.-H.K., S.-W.P., S,-J.P.), Endocrinology and Metabolism (B.-J.K., J.-M.K.), and Health Screening and Promotion Center (H.-K.K., J.C.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Department of Nursing, College of Medicine, Dankook University, Cheonan, Korea (S.H.K.); Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea (H.C.K.); and Research and Development Center, Health Insurance Review and Assessment Service, Seoul, Korea (H.C.K.).
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Her
authors.affiliation: From the Department of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea (G.-M.P., S.H.H.); Departments of Biostatistics (S.H., J.B.L., M.S.L.), Preventive Medicine (M.-W.J.), Cardiology, (J.-M.A., S.-W.L., Y.-H.K., S.-W.P., S,-J.P.), Endocrinology and Metabolism (B.-J.K., J.-M.K.), and Health Screening and Promotion Center (H.-K.K., J.C.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Department of Nursing, College of Medicine, Dankook University, Cheonan, Korea (S.H.K.); Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea (H.C.K.); and Research and Development Center, Health Insurance Review and Assessment Service, Seoul, Korea (H.C.K.).
authors.forename: Jung Bok
authors.initials: JB
authors.lastname: Lee
authors.affiliation: From the Department of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea (G.-M.P., S.H.H.); Departments of Biostatistics (S.H., J.B.L., M.S.L.), Preventive Medicine (M.-W.J.), Cardiology, (J.-M.A., S.-W.L., Y.-H.K., S.-W.P., S,-J.P.), Endocrinology and Metabolism (B.-J.K., J.-M.K.), and Health Screening and Promotion Center (H.-K.K., J.C.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Department of Nursing, College of Medicine, Dankook University, Cheonan, Korea (S.H.K.); Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea (H.C.K.); and Research and Development Center, Health Insurance Review and Assessment Service, Seoul, Korea (H.C.K.).
authors.forename: Moo Song
authors.initials: MS
authors.lastname: Lee
authors.affiliation: From the Department of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea (G.-M.P., S.H.H.); Departments of Biostatistics (S.H., J.B.L., M.S.L.), Preventive Medicine (M.-W.J.), Cardiology, (J.-M.A., S.-W.L., Y.-H.K., S.-W.P., S,-J.P.), Endocrinology and Metabolism (B.-J.K., J.-M.K.), and Health Screening and Promotion Center (H.-K.K., J.C.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Department of Nursing, College of Medicine, Dankook University, Cheonan, Korea (S.H.K.); Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea (H.C.K.); and Research and Development Center, Health Insurance Review and Assessment Service, Seoul, Korea (H.C.K.).
authors.forename: Hyeon Chang
authors.initials: HC
authors.lastname: Kim
authors.affiliation: From the Department of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea (G.-M.P., S.H.H.); Departments of Biostatistics (S.H., J.B.L., M.S.L.), Preventive Medicine (M.-W.J.), Cardiology, (J.-M.A., S.-W.L., Y.-H.K., S.-W.P., S,-J.P.), Endocrinology and Metabolism (B.-J.K., J.-M.K.), and Health Screening and Promotion Center (H.-K.K., J.C.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Department of Nursing, College of Medicine, Dankook University, Cheonan, Korea (S.H.K.); Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea (H.C.K.); and Research and Development Center, Health Insurance Review and Assessment Service, Seoul, Korea (H.C.K.).
authors.forename: Jung-Min
authors.initials: JM
authors.lastname: Ahn
authors.affiliation: From the Department of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea (G.-M.P., S.H.H.); Departments of Biostatistics (S.H., J.B.L., M.S.L.), Preventive Medicine (M.-W.J.), Cardiology, (J.-M.A., S.-W.L., Y.-H.K., S.-W.P., S,-J.P.), Endocrinology and Metabolism (B.-J.K., J.-M.K.), and Health Screening and Promotion Center (H.-K.K., J.C.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Department of Nursing, College of Medicine, Dankook University, Cheonan, Korea (S.H.K.); Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea (H.C.K.); and Research and Development Center, Health Insurance Review and Assessment Service, Seoul, Korea (H.C.K.).
authors.forename: Seung-Whan
authors.initials: SW
authors.lastname: Lee
authors.affiliation: From the Department of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea (G.-M.P., S.H.H.); Departments of Biostatistics (S.H., J.B.L., M.S.L.), Preventive Medicine (M.-W.J.), Cardiology, (J.-M.A., S.-W.L., Y.-H.K., S.-W.P., S,-J.P.), Endocrinology and Metabolism (B.-J.K., J.-M.K.), and Health Screening and Promotion Center (H.-K.K., J.C.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Department of Nursing, College of Medicine, Dankook University, Cheonan, Korea (S.H.K.); Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea (H.C.K.); and Research and Development Center, Health Insurance Review and Assessment Service, Seoul, Korea (H.C.K.). mdyhkim@amc.seoul.kr drchoe@hotmail.com.
authors.forename: Young-Hak
authors.initials: YH
authors.lastname: Kim
authors.affiliation: From the Department of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea (G.-M.P., S.H.H.); Departments of Biostatistics (S.H., J.B.L., M.S.L.), Preventive Medicine (M.-W.J.), Cardiology, (J.-M.A., S.-W.L., Y.-H.K., S.-W.P., S,-J.P.), Endocrinology and Metabolism (B.-J.K., J.-M.K.), and Health Screening and Promotion Center (H.-K.K., J.C.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Department of Nursing, College of Medicine, Dankook University, Cheonan, Korea (S.H.K.); Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea (H.C.K.); and Research and Development Center, Health Insurance Review and Assessment Service, Seoul, Korea (H.C.K.).
authors.forename: Beom-Jun
authors.initials: BJ
authors.lastname: Kim
authors.affiliation: From the Department of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea (G.-M.P., S.H.H.); Departments of Biostatistics (S.H., J.B.L., M.S.L.), Preventive Medicine (M.-W.J.), Cardiology, (J.-M.A., S.-W.L., Y.-H.K., S.-W.P., S,-J.P.), Endocrinology and Metabolism (B.-J.K., J.-M.K.), and Health Screening and Promotion Center (H.-K.K., J.C.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Department of Nursing, College of Medicine, Dankook University, Cheonan, Korea (S.H.K.); Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea (H.C.K.); and Research and Development Center, Health Insurance Review and Assessment Service, Seoul, Korea (H.C.K.).
authors.forename: Jung-Min
authors.initials: JM
authors.lastname: Koh
authors.affiliation: From the Department of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea (G.-M.P., S.H.H.); Departments of Biostatistics (S.H., J.B.L., M.S.L.), Preventive Medicine (M.-W.J.), Cardiology, (J.-M.A., S.-W.L., Y.-H.K., S.-W.P., S,-J.P.), Endocrinology and Metabolism (B.-J.K., J.-M.K.), and Health Screening and Promotion Center (H.-K.K., J.C.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Department of Nursing, College of Medicine, Dankook University, Cheonan, Korea (S.H.K.); Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea (H.C.K.); and Research and Development Center, Health Insurance Review and Assessment Service, Seoul, Korea (H.C.K.).
authors.forename: Hong-Kyu
authors.initials: HK
authors.lastname: Kim
authors.affiliation: From the Department of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea (G.-M.P., S.H.H.); Departments of Biostatistics (S.H., J.B.L., M.S.L.), Preventive Medicine (M.-W.J.), Cardiology, (J.-M.A., S.-W.L., Y.-H.K., S.-W.P., S,-J.P.), Endocrinology and Metabolism (B.-J.K., J.-M.K.), and Health Screening and Promotion Center (H.-K.K., J.C.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Department of Nursing, College of Medicine, Dankook University, Cheonan, Korea (S.H.K.); Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea (H.C.K.); and Research and Development Center, Health Insurance Review and Assessment Service, Seoul, Korea (H.C.K.). mdyhkim@amc.seoul.kr drchoe@hotmail.com.
authors.forename: Jaewon
authors.initials: J
authors.lastname: Choe
authors.affiliation: From the Department of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea (G.-M.P., S.H.H.); Departments of Biostatistics (S.H., J.B.L., M.S.L.), Preventive Medicine (M.-W.J.), Cardiology, (J.-M.A., S.-W.L., Y.-H.K., S.-W.P., S,-J.P.), Endocrinology and Metabolism (B.-J.K., J.-M.K.), and Health Screening and Promotion Center (H.-K.K., J.C.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Department of Nursing, College of Medicine, Dankook University, Cheonan, Korea (S.H.K.); Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea (H.C.K.); and Research and Development Center, Health Insurance Review and Assessment Service, Seoul, Korea (H.C.K.).
authors.forename: Seong-Wook
authors.initials: SW
authors.lastname: Park
authors.affiliation: From the Department of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea (G.-M.P., S.H.H.); Departments of Biostatistics (S.H., J.B.L., M.S.L.), Preventive Medicine (M.-W.J.), Cardiology, (J.-M.A., S.-W.L., Y.-H.K., S.-W.P., S,-J.P.), Endocrinology and Metabolism (B.-J.K., J.-M.K.), and Health Screening and Promotion Center (H.-K.K., J.C.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Department of Nursing, College of Medicine, Dankook University, Cheonan, Korea (S.H.K.); Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea (H.C.K.); and Research and Development Center, Health Insurance Review and Assessment Service, Seoul, Korea (H.C.K.).
authors.forename: Seung-Jung
authors.initials: SJ
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D016016:Proportional Hazards Models; D056910:Republic of Korea / Q000453:epidemiology; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors
keywords: cardiovascular diseases; coronary disease; prevention and control