New QRISK 3 CVD risk calculator now available
A new study has announced the new QRISK3 cardiovascular disease risk prediction algorithm. The calculator is used to work out the risk of developing a heart attack or stroke over the next 10 years. The risk calculator is designed for use in the UK.
A total of 981 practices with 7.89 million patients in the UK were used to develop the risk scores and 328 practices with 2.67 patients were used to validate the scores.Cox proportional hazards models were used in the derivation cohort to derive separate risk equations in men and women for evaluation at 10 years.
A number of new risk factors were added into the QRISK3 algorithm. Risk factors in the algorithm included those already in QRISK2 and the new risk factors included chronic kidney disease, a measure of systolic blood pressure variability, migraine, corticosteroids, systemic lupus erythematosus (SLE), atypical antipsychotics, severe mental illness, and HIV/AIDs. Erectile dysfunction was also considered in men.
Nearly 364,000 incident cases of cardiovascular disease were identified in the derivation cohort during follow-up arising from 50.8 million person years of observation. All the new risk factors considered met the model inclusion criteria except for HIV/AIDS, which was not statistically significant. The models had good calibration and high levels of explained variation and discrimination. In women, the algorithm explained 59.6% of the variation in time to diagnosis of cardiovascular disease and 54.8% in men.
The overall performance of the updated QRISK3 algorithms was similar to the QRISK2 algorithms.
The QRISK3 2017 risk calculator is now available at www.qrisk.org/three/
Inclusion of additional clinical variables into the QRISK3 algorithm will help to more accurately identify people at most risk of heart disease and stroke.
Hippisley-Cox J et al. Development and validation of QRISK3 risk prediction algorithms to estimate future risk of cardiovascular disease: prospective cohort study. BMJ 2017; doi: https://doi.org/10.1136/bmj.j2099