Cardiovascular risk prediction models for women in the general population: A systematic review

Sara J. Baart, Veerle Dam, Luuk J.J. Scheres, Johanna A.A.G. Damen, René Spijker, Ewoud Schuit, Thomas P.A. Debray, Bart C.J.M. Fauser, Eric Boersma, the CREW Consortium, Karel G.M. Moons, Yvonne T. van der Schouw*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Aim:

To provide a comprehensive overview of cardiovascular disease (CVD) risk prediction models for women and models that include female-specific predictors. 

Methods:

We performed a systematic review of CVD risk prediction models for women in the general population by updating a previous review. We searched Medline and Embase up to July 2017 and included studies in which; (a) a new model was developed, (b) an existing model was validated, or (c) a predictor was added to an existing model. 

Results:

A total of 285 prediction models for women have been developed, of these 160 (56%) were female-specific models, in which a separate model was developed solely in women and 125 (44%) were sex-predictor models. Out of the 160 female-specific models, 2 (1.3%) included one or more female-specific predictors (mostly reproductive risk factors). A total of 591 validations of sex-predictor or female-specific models were identified in 206 papers. Of these, 333 (56%) validations concerned nine models (five versions of Framingham, SCORE, Pooled Cohort Equations and QRISK). The median and pooled C statistics were comparable for sex-predictor and female-specific models. In 260 articles the added value of new predictors to an existing model was described, however in only 3 of these female-specific predictors (reproductive risk factors) were added. 

Conclusions:

There is an abundance of models for women in the general population. Female-specific and sex-predictor models have similar predictors and performance. Female-specific predictors are rarely included. Further research is needed to assess the added value of female-specific predictors to CVD models for women and provide physicians with a well-performing prediction model for women.

Original languageEnglish
Article numbere0210329
JournalPLoS ONE
Volume14
Issue number1
DOIs
Publication statusPublished - 8 Jan 2019

Bibliographical note

Publisher Copyright:
© 2019 Baart et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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