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Table 3 Cox proportional hazards models: time to incident CVD, overall and by sex and race: risk scores and MetS severity

From: Assessing the added predictive ability of a metabolic syndrome severity score in predicting incident cardiovascular disease and type 2 diabetes: the Atherosclerosis Risk in Communities Study and Jackson Heart Study

Model

Framingham risk score (D’Agostino et al. 2008)

ASCVD risk score (Goff et al. 2013)

Overall

Sex and race specific analysis

Overall

Sex and race specific analysis

n = 12,553

White men

n = 3900

White women

n = 4715

Black men

n = 1478

Black women

n = 2460

n = 12,553

White men

n = 3900

White women

n = 4715

Black men

n = 1478

Black women

n = 2460

Model Ab

 CVD risk score HR (95% CI)

2.38 (2.26, 2.52)

2.03 (1.85, 2.22)

2.47 (2.20, 2.76)

2.49 (2.02, 3.08)

2.59 (2.13, 3.15)

2.68 (2.51, 2.86)

2.27 (2.03, 2.54)

2.74 (2.40, 3.12)

3.47 (2.56, 4.71)

2.43 (2.01, 2.94)

 Model AIC

30,916.55

15,159.02

7166.26

2361.36

2163.07

30,911.43

15,155.87

7146.23

2367.17

2166.56

 C statistic

0.72 (0.71, 0.74)

0.64 (0.62, 0.66)

0.70 (0.68, 0.73)

0.71 (0.67, 0.75)

0.72 (0.68, 0.77)

0.72 (0.71, 0.73)

0.64 (0.62, 0.65)

0.71 (0.68, 0.73)

0.70 (0.66, 0.74)

0.73 (0.68, 0.77)

Model Bb

 MetS severity HR (95% CI)

1.77 (1.66, 1.88)

1.49 (1.37, 1.63)

1.86 (1.65, 2.10)

1.64 (1.33, 2.02)

1.62 (1.32, 2.00)

1.77 (1.66, 1.88)

1.49 (1.37, 1.63)

1.86 (1.65, 2.10)

1.64 (1.33, 2.02)

1.62 (1.32, 2.00)

 Model AIC

31,394.43

15,265.20

7262.83

2405.99

2224.53

31,394.43

15,265.20

7262.83

2405.99

2224.53

 C statistic

0.64 (0.63, 0.65)

0.59 (0.57, 0.60)

0.64 (0.61, 0.66)

0.65 (0.61, 0.69)

0.63 (0.58, 0.67)

0.64 (0.63, 0.65)

0.59 (0.57, 0.60)

0.64 (0.61, 0.66)

0.65 (0.61, 0.69)

0.63 (0.58, 0.67)

Model Cb

 CVD risk score HR (95% CI)

2.33 (2.19, 2.48)

1.94 (1.74, 2.16)

2.41 (2.08, 2.78)

2.39 (1.90, 3.01)

2.52 (2.04, 3.11)

2.54 (2.36, 2.72)

2.11 (1.87, 2.39)

2.53 (2.17, 2.94)

3.14 (2.28, 4.33)

2.38 (1.94, 2.91)

 MetS severity HR (95% CI)

1.06 (0.98, 1.14)

1.09 (0.98, 1.21)

1.04 (0.89, 1.22)

1.12 (0.88, 1.42)

1.09 (0.86, 1.38)

1.14 (1.06, 1.22)

1.15 (1.04, 1.27)

1.16 (1.00, 1.34)

1.29 (1.03, 1.61)

1.08 (0.85, 1.36)

 Model AIC

30,880.50

15,152.18

7159.64

2360.46

2162.74

30,860.53

15,146.65

7136.46

2361.73

2164.39

 C statistic

0.72 (0.71, 0.73)

0.64 (0.62, 0.66)

0.70 (0.67, 0.72)

0.71 (0.67, 0.75)

0.72 (0.68, 0.77)

0.72 (0.71, 0.73)

0.64 (0.62, 0.66)

0.70 (0.68, 0.73)

0.70 (0.67, 0.74)

0.72 (0.68, 0.77)

 IDIa (95% CI)

− 0.00 (− 0.00, 0.00)

− 0.00 (− 0.00, 0.00)

− 0.00 (− 0.00, 0.00)

− 0.00 (− 0.00, 0.00)

− 0.00 (− 0.00, 0.00)

− 0.00 (− 0.00, 0.00)

0.00 (− 0.00, 0.00)

− 0.00 (− 0.01, 0.00)

− 0.00 (− 0.01, 0.00)

− 0.00 (− 0.01, 0.00)

 Continuous NRIa (95% CI)

0.16 (0.08, 0.23)

0.02 (− 0.08, 0.13)

0.22 (0.04, 0.42)

0.20 (0.03, 0.45)

0.19 (− 0.07, 0.42)

0.15 (0.05, 0.23)

0.04 (− 0.08, 0.15)

0.20 (0.01, 0.40)

0.24 (0.05, 0.50)

0.37 (0.13, 0.62)

 Event NRIa (95% CI)

0.06 (− 0.02, 0.14)

− 0.03 (− 0.14, 0.07)

0.08 (− 0.11, 0.27)

0.14 (− 0.05, 0.36)

0.09 (− 0.17, 0.34)

0.10 (0.01, 0.18)

− 0.02 (− 0.12, 0.08)

0.06 (− 0.13, 0.27)

0.16 (− 0.05, 0.40)

0.30 (0.06, 0.55)

 Non-event NRIa (95% CI)

0.10 (0.08, 0.11)

0.05 (0.03, 0.09)

0.14 (0.11, 0.16)

0.06 (0.02, 0.11)

0.10 (0.05, 0.13)

0.05 (0.03, 0.07)

0.06 (0.03, 0.08)

0.14 (0.11, 0.16)

0.08 (0.03, 0.14)

0.07 (0.02, 0.10)

Model Db

 CVD × MetS p value

p < 0.0001

p < 0.0001

p < 0.0001

p = 0.4329

p = 0.0095

p < 0.0001

p < 0.0001

p = 0.0032

p = 0.5687

p = 0.1049

 Model AIC

30,810.04

15,134.30

7142.84

2361.83

2157.61

30,809.03

15,130.44

7129.02

2363.41

2163.73

 C statistic

0.72 (0.71, 0.73)

0.64 (0.62, 0.66)

0.70 (0.67, 0.72)

0.71 (0.67, 0.75)

0.72 (0.68, 0.77)

0.72 (0.71, 0.73)

0.64 (0.62, 0.66)

0.70 (0.68, 0.72)

0.70 (0.66, 0.74)

0.72 (0.68, 0.76)

 IDIa (95% CI)

− 0.00 (− 0.01, 0.00)

− 0.00 (− 0.00, 0.00)

− 0.00 (− 0.02, 0.01)

− 0.00 (− 0.00, 0.00)

− 0.00 (− 0.02, 0.01)

− 0.00 (− 0.01, 0.00)

0.00 (− 0.00, 0.00)

− 0.00 (− 0.01, 0.00)

− 0.00 (− 0.01, − 0.00)

− 0.00 (− 0.01, 0.01)

 Continuous NRIa (95% CI)

0.42 (0.35, 0.49)

0.20 (0.10, 0.32)

0.56 (0.36, 0.73)

0.14 (− 0.09, 0.48)

0.48 (0.25, 0.74)

0.38 (0.30, 0.45)

0.22 (0.10, 0.32)

0.46 (0.26, 0.67)

0.18 (− 0.02, 0.43)

0.32 (0.03, 0.59)

 Event NRIa (95% CI)

0.39 (0.32, 0.45)

0.33 (0.25, 0.43)

0.50 (0.34, 0.67)

0.09 (− 0.13, 0.39)

0.46 (0.21, 0.70)

0.27 (0.19, 0.34)

0.31 (0.23, 0.41)

0.38 (0.19, 0.57)

0.08 (− 0.13, 0.33)

0.17 (− 0.11, 0.43)

 Non-event NRIa (95% CI)

0.03 (0.01, 0.05)

− 0.13 (− 0.16, − 0.09)

0.06 (0.02, 0.08)

0.05 (− 0.00, 0.10)

0.02 (− 0.03, 0.06)

0.11 (0.09, 0.13)

− 0.09 (− 0.13, − 0.07)

0.08 (0.05, 0.11)

0.10 (0.05, 0.15)

0.15 (0.11, 0.19)

  1. All models controlled for study site. The risk scores were standardized to facilitate comparability of HR’s with MetS severity; model fit/prediction statistics included scores on their original scale
  2. Statistically significant (p < 0.05) HR’s (different than 1) and IDI’s/NRI’s (different than 0) were italic for ease of display
  3. a IDI and NRI computed relative to Model A
  4. b Predictors included in models are as follows: Model A: risk score only; Model B: MetS severity only; Model C: risk score and MetS severity; Model D risk score, MetS severity, and risk score by MetS severity interaction