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The addition of depression to the Framingham Risk Equation model for predicting coronary heart disease risk in women

Version 2 2024-06-06, 06:30
Version 1 2016-03-09, 12:34
journal contribution
posted on 2024-06-06, 06:30 authored by A O'Neil, AJ Fisher, KJ Kibbey, Felice JackaFelice Jacka, MA Kotowicz, Lana WilliamsLana Williams, Amanda StuartAmanda Stuart, Michael BerkMichael Berk, PA Lewandowski, JJ Atherton, CB Taylor, Julie PascoJulie Pasco
BACKGROUND: Depression is widely considered to be an independent and robust predictor of Coronary Heart Disease (CHD), however is seldom considered in the context of formal risk assessment. We assessed whether the addition of depression to the Framingham Risk Equation (FRE) improved accuracy for predicting 10-year CHD in a sample of women. DESIGN: A prospective, longitudinal design comprising an age-stratified, population-based sample of Australian women collected between 1993 and 2011 (n=862). METHODS: Clinical depressive disorder was assessed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (SCID-I/NP), using retrospective age-of-onset data. A composite measure of CHD included non-fatal myocardial infarction, unstable angina coronary intervention or cardiac death. Cox proportional-hazards regression models were conducted and overall accuracy assessed using area under receiver operating characteristic (ROC) curve analysis. RESULTS: ROC curve analyses revealed that the addition of baseline depression status to the FRE model improved its overall accuracy (AUC:0.77, Specificity:0.70, Sensitivity:0.75) when compared to the original FRE model (AUC:0.75, Specificity:0.73, Sensitivity:0.67). However, when calibrated against the original model, the predicted number of events generated by the augmented version marginally over-estimated the true number observed. CONCLUSIONS: The addition of a depression variable to the FRE equation improves the overall accuracy of the model for predicting 10-year CHD events in women, however may over-estimate the number of events that actually occur. This model now requires validation in larger samples as it could form a new CHD risk equation for women.

History

Journal

Preventive Medicine

Volume

87

Pagination

115-120

Location

United States

ISSN

0091-7435

eISSN

1096-0260

Language

English

Publication classification

C Journal article, C1 Refereed article in a scholarly journal

Copyright notice

2016, Elsevier

Publisher

ACADEMIC PRESS INC ELSEVIER SCIENCE