The DOI matches its Crossref record; 25 of the 25 references it cites were found in a registry or an index.
Are the Framingham and PROCAM coronary heart disease risk functions applicable to different European populations? The PRIME Study
Abstract
AIMS: To assess whether the Framingham and PROCAM risk functions were applicable to men in Belfast and France. METHODS AND RESULTS: We performed an external validation study within the PRIME (Prospective Epidemiological Study of Myocardial Infarction) cohort study. It comprised men recruited in Belfast (2399) and France (7359) who were aged 50 to 59 years, free of CHD at baseline (1991 to 1993) and followed over 5 years for CHD events (coronary death, myocardial infarction, angina pectoris). We compared the relative risks of CHD associated with the classic risk factors in PRIME with those in Framingham and PROCAM cohorts. We then compared the number of predicted and observed 5-year CHD events (calibration). Finally, we estimated the ability of the risk functions to separate high risk from low risk subjects (discrimination). The relative risk of CHD calculated for the various factors in the PRIME population were not statistically different from those published in the Framingham and PROCAM risk functions. The number of CHD events predicted by these risk functions however clearly overestimated those observed in Belfast and France. The two risk functions had a similar ability to separate high risk from low risk subjects in Belfast and France (c-statistic range: 0.61-0.68). CONCLUSION: The Framingham and PROCAM risk functions should not be used to estimate the absolute CHD risk of middle-aged men in Belfast and France without any CHD history because of a clear overestimation. Specific population risk functions are needed.
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“For example, similar relative risks were obtained for the classic cardiovascular risk factors for men living in Northern Ireland, France, the USA and Germany, despite the fact that the underlying risk of coronary heart disease varies substantially between these countries [ 166 , 167 ].”
From Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration (2007) · cites this paper as [166]
In the citing paper
“Relative effects or associations tend to be more consistent across studies and populations than absolute measures, but what often tends to be the case may be irrelevant in a particular instance.”
From Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration (2007) · cites this paper as [166]
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Cites
Prediction of coronary heart disease using risk factor categories
Wilson, P. W. F., D’Agostino, R. B., Levy, D., Belanger, A. M., Silbershatz, H., & Kannel, W. B. (1998) · Circulation · doi:10.1161/01.cir.97.18.1837 · Cited by 9,581
Cardiovascular Survey Methods.
Rose, G., & Blackburn, H. (1968) · Annals of Internal Medicine · doi:10.7326/0003-4819-69-6-1335_2 · Cited by 3,090
D'Agostino, R. B., Grundy, S., Sullivan, L. M., Wilson, P., & for the CHD Risk Prediction Group (2001) · JAMA · doi:10.1001/jama.286.2.180 · Cited by 2,108
An updated coronary risk profile. A statement for health professionals.
Anderson, K. M., Wilson, P. W., Odell, P. M., & Kannel, W. B. (1991) · Circulation · doi:10.1161/01.cir.83.1.356 · Cited by 1,834
AN INVESTIGATION OF CORONARY HEART DISEASE IN FAMILIES
Kannel, W. B., Feinleib, M., McNAMARA, P. M., Garrison, R. J., & Castelli, W. P. (1979) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a112813 · Cited by 1,639
Assmann, G., Cullen, P., & Schulte, H. (2002) · Circulation · doi:10.1161/hc0302.102575 · Cited by 1,541
Prevention of coronary heart disease in clinical practice
Pyörälà, K., Backer, G. D., Graham, I. M., Poole-Wilson, P. A., & Wood, D. A. (1994) · European Heart Journal · doi:10.1093/oxfordjournals.eurheartj.a060388 · Cited by 1,161
Kuulasmaa, K., Tunstall‐Pedoe, H., Dobson, A. J., Fortmann, S. P., Sans, S., Tolonen, H. K., Evans, A., & Ferrario, M. (2000) · The Lancet · doi:10.1016/s0140-6736(99)11180-2 · Cited by 950
The Framingham Offspring Study
Allhoff, P., Laaser, U., & Heinrich, J. (1991) · Springer eBooks · doi:10.1007/978-3-642-95642-3_25 · Cited by 832
Hense, H. (2003) · European Heart Journal · doi:10.1016/s0195-668x(03)00081-2 · Cited by 370
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Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: executive summary
Rydén, L., Standl, E., Bartnik, M., den Berghe, G. V., Betteridge, J. D., de Boer, M., Cosentino, F., Jönsson, B., Laakso, M., Malmberg, K., et al. (2007) · European Heart Journal · doi:10.1093/eurheartj/ehl260 · Cited by 1,644
Metadata
- Authors
- Empana, J.
- Affiliations
- Inserm (FR)
- Corresponding author
- Empana, J
- ORCID
- Empana, J
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 2003-11
- Volume
- 24
- Issue
- 21
- Pages
- 1903-1911
- ISSN
- 0195-668X (ISSN-L)
- OpenAlex
- W2087942162
- Cited by
- 263
- References
- 25
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 3 · 2023: 5 · 2022: 5 · 2021: 4 · 2020: 5 · 2019: 5 · 2018: 6 · 2017: 4 · 2016: 6 · 2015: 12 · 2014: 6 · 2013: 12 · 2012: 12
- FWCI
- 19.09
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Heart Journal (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Institut National de la Santé et de la Recherche Médicale
- Northern Ireland Chest Heart and Stroke
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
- Keywords
- coronary heart disease risk prediction, Framingham risk equation, external validation, PRIME study, middle-aged men, discrimination (statistics), Belfast, France
- MeSH terms
- Adult, Aged, Angina Pectoris, Coronary Disease, France, Humans, Male, Middle Aged, Myocardial Infarction, Northern Ireland, Predictive Value of Tests, Prognosis, Prospective Studies, Risk Factors, Sensitivity and Specificity, Cohort Studies, Proportional Hazards Models, Risk Assessment
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