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Predicting Coronary Heart Disease Using Risk Factor Categories for a Japanese Urban Population, and Comparison with the Framingham Risk Score: The Suita Study
Open accessAbstract
AIM: The Framingham risk score (FRS) is one of the standard tools used to predict the incidence of coronary heart disease (CHD). No previous study has investigated its efficacy for a Japanese population cohort. The purpose of this study was to develop new coronary prediction algorithms for the Japanese population in the manner of the FRS, and to compare them with the original FRS. METHODS: Our coronary prediction algorithms for Japanese were based on a large population-based cohort study (Suita study). The study population comprised 5,521 healthy Japanese. They were followed-up for 11.8 years on average, and 213 cases of CHD were observed. Multiple Cox proportional hazard model by stepwise selection was used to construct the prediction model. RESULTS: Our coronary prediction algorithms for Japanese patients were based on a large populationbased cohort study (the Suita study). A multiple Cox proportional hazard model by stepwise selection was used to construct the prediction model. The C-statistics showed that the new model had better accuracy than the original and recalibrated Framingham scores. The net reclassification improvement (NRI) by the Suita score with the inclusion of CKD was 41.2% (P＜0.001) compared with the original FRS. The recalibration of the FRS slightly improved the efficiency of the prediction, but it was still worse than the Suita score with the CKD model. The calibration analysis suggested that the original FRS and the recalibrated FRS overestimated the risk of CHD in the Japanese population. The Suita score with CKD more accurately predicted the risk of CHD. CONCLUSION: The FRS and recalibrated FRS overestimated the 10-year risk of CHD for the Japanese population. A predictive score including CKD as a coronary risk factor for the Japanese population was more accurate for predicting CHD than the original Framingham risk scores in terms of the C-statics and NRI.
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“There are several assessment tool that predict the absolute risk of ASCVD in the Japanese population.”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [161]
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“In terms of absolute risk, aging enhances the risk for ASCVD and death from it much more than any other risk factors160–162).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [161]
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Doi, H., Ishigami, T., Nakashima-Sasaki, R., Kino, T., Chen, L., Arakawa, K., Teranaka, S., Minegishi, S., Abe, K., Ishikawa, T., et al. (2018) · Clinical and Experimental Hypertension · doi:10.1080/10641963.2018.1465072 · Cited by 14
“Previous studies, including one from our group, demonstrated significant correlations of AVI with cardiac function and augment index score and of API with Framingham Cardiovascular Risk Scores, Suita Scores(18).”
ResultCost‐Effectiveness of Radiofrequency Renal Denervation for Uncontrolled Hypertension in Japan
Kario, K., Cao, K. N., Tanaka, Y., Ryschon, A. M., & Pietzsch, J. B. (2024) · Journal of Clinical Hypertension · doi:10.1111/jch.14922 · Cited by 13
Cardiovascular Risk Assessment Chart by Dietary Factors in Japan - NIPPON DATA80.
Kondo, K., Miura, K., Tanaka-Mizuno, S., Kadota, A., Arima, H., Okuda, N., Fujiyoshi, A., Miyagawa, N., Yoshita, K., Okamura, T., et al. (2019) · Circulation Journal · doi:10.1253/circj.cj-18-1002 · Cited by 12
Self-citationOkamoto, Y., Miyoshi, T., Ichikawa, K., Takaya, Y., Nakamura, K., & Ito, H. (2022) · Journal of Cardiovascular Development and Disease · doi:10.3390/jcdd9110368 · Cited by 12
“The Suita score was proposed and validated to estimate the 10-year risk of coronary heart disease in the Japanese population [20].”
MethodLi, H., Wang, Y., Xue, Y., Li, Y., Wu, H., & Wu, J. (2023) · BMC Public Health · doi:10.1186/s12889-023-16297-0 · Cited by 14
Tabara, Y., Matsumoto, T., Murase, K., Setoh, K., Kawaguchi, T., Wakamura, T., Hirai, T., Chin, K., & Matsuda, F. (2024) · Journal of Hypertension · doi:10.1097/hjh.0000000000003781 · Cited by 11
Kubo, K., Hirata, A., Kadota, A., Harada, A., Nakamura, Y., Hayakawa, T., Takashima, N., Fujiyoshi, A., Okami, Y., Kita, Y., et al. (2024) · Circulation Journal · doi:10.1253/circj.cj-23-0847 · Cited by 11
“25 26 In contrast, current drinking and non-HDL-C were factors inversely associated with HF mortality.”
Self-citationAtherosclerotic Diseases in Chronic Kidney Disease
Nakano, T. (2024) · Journal of Atherosclerosis and Thrombosis · doi:10.5551/jat.rv22030 · Cited by 14
“In a clinical trial, a post hoc analysis of pre-dialysis CKD patients showed that cholesterol) showed that the incidence of coronary artery disease was 1.34 times higher in CKD stage 3 and 4.01 times higher in CKD stages 4 and 5 than in the general population 13) .”
InfluentialMori, R., Miyata, M., Kubozono, T., Inadome, N., Kawasoe, S., Ojima, S., Kawabata, T., Salim, A. A., Miyahara, H., Tokushige, K., et al. (2022) · Journal of Atherosclerosis and Thrombosis · doi:10.5551/jat.63557 · Cited by 11
Increased arterial pressure volume index and cardiovascular risk score in China
Jin, L., Zhang, M., Sha, L., Cao, M., Tong, L., Chen, Q., Shen, C., Du, L., Liu, L., & Li, Z. (2023) · BMC Cardiovascular Disorders · doi:10.1186/s12872-022-03035-4 · Cited by 11
“Thus, API is closely related to cardiac function, and is significantly and independently associated with CVD risk scores [3, 10, 11].”
BackgroundNakai, M., Miyamoto, Y., Higashiyama, A., Murakami, Y., Nishimura, K., Yatsuya, H., Saitoh, S., Sakata, K., Iso, H., Miura, K., et al. (2016) · Journal of Atherosclerosis and Thrombosis · doi:10.5551/jat.31286 · Cited by 10
Self-citationLiu, L., Tang, Z., Li, X., Luo, Y., Guo, J. C., Li, H., Liu, X., Tao, L., Wang, W., Yan, A., et al. (2016) · Medicine · doi:10.1097/md.0000000000002997 · Cited by 10
“The optimal CAD model was created by adding HDL-C, LDL-C, and triglycerides to the basic CAD model, evaluating by the AUC and continuous NRI.47 Another study composed of 5521 healthy Japanese, and during the follow-up, 213 cases of CAD events were observed.”
BackgroundResultInfluentialLima, A. M., Werneck, A. O., Cyrino, E. S., & Farinatti, P. (2019) · BMC Public Health · doi:10.1186/s12889-019-7716-y · Cited by 11
“Although previous studies have demonstrated the applicability of the FRS in other populations (42-44), we have to acknowledge that this may have interfered with the sensitivity of our results (see http://www.”
ResultTabara, Y., Yamada, H., Setoh, K., Matsukawa, M., Takahashi, M., Kawaguchi, T., Nakayama, T., Matsuda, F., & Kosugi, S. (2021) · Journal of Hypertension · doi:10.1097/hjh.0000000000002964 · Cited by 10
“We considered individuals who underwent coronary artery bypass grafting or angioplasty as having had MACE similarly to the other epidemiological studies [20,21] to identify individuals with the acute coronary syndrome.”
BackgroundResultFuruya, C., Hashimoto, Y., Morishita, S., Inano, T., Ochiai, T., Shirane, S., Edahiro, Y., Araki, M., Ando, M., & Komatsu, N. (2022) · Journal of Thrombosis and Thrombolysis · doi:10.1007/s11239-022-02751-0 · Cited by 11
“Since the treatment of HT, DM, and hyper-LDL cholesterolemia as well as the cessation of smoking are prioritized in the management and prevention of cerebro-cardiovascular diseases [12, 33, 35, 36], additional interventions for hypertriglyceridemia may also effectively prevent thrombosis in ET with hypertriglyceridemi…”
BackgroundManita, D., Yoshida, H., & Hirowatari, Y. (2016) · Journal of Atherosclerosis and Thrombosis · doi:10.5551/jat.34728 · Cited by 10
Aging-associated inflammation and fibrosis in arachnoid membrane
Suzuki, H., Mikami, T., Iwahara, N., Akiyama, Y., Wanibuchi, M., Komatsu, K., Yokoyama, R., Hirano, T., Hosoda, R., Horio, Y., et al. (2021) · BMC Neurology · doi:10.1186/s12883-021-02202-y · Cited by 8
“The degree of atherosclerosis was determined using the ASCVD score and Suita score [18, 19].”
Methodde Souza-Lima, J., Matsudo, S. M., Valdívia-Moral, P., Pérez, W., Drenowatz, C. J., Zenteno, J. S., & Ferrari, G. (2023) · BMC Geriatrics · doi:10.1186/s12877-023-04410-2 · Cited by 10
“The method was validated in the Latin American population and used in other studies [11, 22–25].”
MethodSekizuka, H., Hoshide, S., Kabutoya, T., & Kario, K. (2021) · International Heart Journal · doi:10.1536/ihj.21-309 · Cited by 9
Investigation into Lipid Management in Acute Coronary Syndrome Patients from the EXPLORE-J Study
Nakamura, M., Ako, J., Arai, H., Hirayama, A., Murakami, Y., Nohara, A., Uno, K., Ozaki, A., & Harada‐Shiba, M. (2018) · Journal of Atherosclerosis and Thrombosis · doi:10.5551/jat.45583 · Cited by 9
Coronary artery calcium score may be a novel predictor of COVID-19 prognosis: a retrospective study
Takeshita, Y., Terada, J., Fujita, R., Hirasawa, Y., Kinoshita, T., Isaka, Y., Kinouchi, T., Tajima, H., Tada, Y., Kiryu, S., et al. (2021) · BMJ Open Respiratory Research · doi:10.1136/bmjresp-2021-000923 · Cited by 9
Impact of retinal vein occlusion on cardiovascular events in elderly Japanese patients
Umeya, R., Yoshida, Y., & Ono, K. (2021) · Medicine · doi:10.1097/md.0000000000028424 · Cited by 9
“Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were divided into 4 categories, in accordance with a previous report([13]): SBP< 120 and DBP<80; 120 SBP<140 or 80 DBP<90; 140 SBP<160 or 90 DBP<100; SBP≥160; or DBP≥100.”
MethodToda, H., Nomura, S., Gilmour, S., Tsubokura, M., Oikawa, T., Lee, K., Kiyabu, G., & Shibuya, K. (2017) · BMJ Open · doi:10.1136/bmjopen-2017-018502 · Cited by 9
Nishimoto, M., Tagawa, M., Matsui, M., Eriguchi, M., Samejima, K., Iseki, K., Iseki, C., Asahi, K., Yamagata, K., Konta, T., et al. (2019) · Scientific Reports · doi:10.1038/s41598-019-49003-5 · Cited by 9
Watanabe, K., Takakubo, N., Saigusa, T., Nagasawa, A., Yamana, M., Ojima, M., Kameda, W., Susa, S., Ishizawa, K., & Ishihara, H. (2022) · International Journal of Hypertension · doi:10.1155/2022/2760027 · Cited by 8
Diabetes screening intervals based on risk stratification
Ohde, S., McFadden, E. C., Deshpande, G. A., Yokomichi, H., Takahashi, O., Fukui, T., Perera, R., & Yamagata, Z. (2016) · BMC Endocrine Disorders · doi:10.1186/s12902-016-0139-1 · Cited by 8
“BMI and Framingham Risk Score parameters were collected during the routine health check up at the same time and in the same facility in which HbA1c was measured; the Framingham Risk Score has been previously validated in the Japanese population [24].”
MethodDiabetes and lifetime risk of stroke and subtypes in an urban middle-aged population
Turin, T. C., Okamura, T., Rumana, N., Afzal, A. R., Watanabe, M., Higashiyama, A., Nakao, Y. M., Nakai, M., Takegami, M., Nishimura, K., et al. (2017) · Journal of Diabetes and its Complications · doi:10.1016/j.jdiacomp.2017.02.002 · Cited by 8
Self-citation
Metadata
- Authors
- Nishimura, K., Okamura, T., Watanabe, M., Nakai, M., Takegami, M., Higashiyama, A., Kokubo, Y., Okayama, A., & Miyamoto, Y.
- Affiliations
- National Cerebral and Cardiovascular Center (JP)
- Keio University (JP)
- Hyogo Medical University (JP)
- Japan Anti Tuberculosis Association (JP)
- ORCID
- Venue
- Journal of Atherosclerosis and Thrombosis
- Publisher
- Japan Atherosclerosis Society
- Published
- 2014
- Volume
- 21
- Issue
- 8
- Pages
- 784-798
- ISSN
- 1340-3478 (ISSN-L)
- 1880-3873
- PMC
- PMC5090819
- OpenAlex
- W2043022783
- Cited by
- 228
- References
- 58
- Citations by year
- 2026: 10 · 2025: 13 · 2024: 25 · 2023: 25 · 2022: 34 · 2021: 33 · 2020: 20 · 2019: 19 · 2018: 20 · 2017: 10 · 2016: 12 · 2015: 4 · 2014: 2
- FWCI
- 9.29
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-sa
- Locations
- Journal of Atherosclerosis and Thrombosis (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- National Cerebral and Cardiovascular Center (22-4-5)
- Japan Society for the Promotion of Science (25293147)
- 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 artery disease, Framingham risk score, risk prediction model, Japanese population, chronic kidney disease, Suita Study, risk overestimation, net reclassification improvement, 10-year risk, urban population
- MeSH terms
- Adult, Aged, Algorithms, Coronary Disease, Female, Follow-Up Studies, Humans, Japan, Male, Middle Aged, Prognosis, Risk Factors, Urban Population, Cohort Studies, Biomarkers, Incidence, Proportional Hazards Models, Case-Control Studies, Risk Assessment
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