Table 2.
Baseline characteristics of the external validation cohorts
| CPRD | NHSE SDE | HUNT3 | HUNT4 | NORCOR | Nor-COAST | BACS/BAMI | SWEDEHEART | |
|---|---|---|---|---|---|---|---|---|
| Country | UK | UK | Norway | Norway | Norway | Norway | Spain | Sweden |
| European risk region | Low risk | Low risk | Low risk | Low risk | Low risk | Low risk | Low risk | Moderate risk |
| Number of patients | 147 566 | 931 460 | 5698 | 6046 | 1112 | 654 | 946 | 87 847 |
| Age (years) | 71 ± 10 | 66 ± 9 | 69 ± 11 | 70 ± 10 | 62 ± 9 | 73 ± 10 | 62 ± 12 | 64 ± 9 |
| Male sex | 59 (87 554) | 70 (656 125) | 57 (3249) | 58 (3486) | 79 (879) | 42 (274) | 76 (720) | 74 (64 759) |
| Current smoking | 24 (34 956) | 20 (181 400) | 23 (1291) | 13 (786) | 21 (233) | 9.8 (64) | 13 (127) | 12 (10 156) |
| Systolic blood pressure (mmHg) | 137 [125–146] | 130 [120–140] | 135 [122–148] | 134 [121–147] | 136 [125–150] | 140 [128–153] | 130 [120–140] | 130 [120–140] |
| BMI (kg/m2) | 28 [24–3] | 29 [25–33] | - | - | 28 [26–31] | - | 28 [26–31] | 27 [25–30] |
| C-reactive protein (mg/L) | - | - | 1.6 [0.8–3.5] | 1.3 [0.7–2.7] | 1.6 [0.8–2.9] | 1.8 [0.8–3.9] | 1.0 [0.3–3.0] | 5.0 [2.0–9.0] |
| eGFR (mL/min/1.73 m2) | 68 [56–81] | 85 [71–96] | 85 [70–95] | 80 [66–90] | 72 [57–89] | 75 [61–87] | 80 [65–92] | 97 [87–104] |
| Total cholesterol (mmol/L) | 4.5 [3.9–5.1] | 3.9 [3.3–4.7] | 5.0 [4.3–6.0] | 4.5 [3.8–5.5] | 3.9 [3.3–4.6] | 3.9 [3.4–4.4] | 3.7 [3.2–4.2] | 3.7 [3.2–4.3] |
| HDL cholesterol (mmol/L) | 1.3 [1.1–1.6] | 1.2 [1.0–1.4] | 1.2 [1.0–1.5] | 1.3 [1.0–1.5] | 1.1 [0.9–1.3] | 1.4 [1.1–1.8] | 1.0 [0.9–1.2] | 1.2 [1.0–1.4] |
| LDL cholesterol (mmol/L) | - | - | 3.4 [2.7–4.2] | 2.8 [2.2–3.7] | 1.9 [1.5–2.5] | 2.0 [1.6–2.5] | 2.0 [1.7–2.4] | 1.9 [1.5–2.3] |
| Triglycerides (mmol/L) | 1.3 [1.0–1.9] | 1.5 [1.1–2.1] | 1.6 [1.1–2.2] | 1.5 [1.0–2.1] | - | 0.9 [0.7–1.3] | 1.1 [0.9–1.6] | 1.3 [0.9–1.8] |
| Diabetes mellitus | 19 (28 476) | 25 (236 590) | 14 (786) | 16 (942) | 17 (185) | 20 (131) | 24 (231) | 23 (20 329) |
| History of coronary artery disease | 70 (102 958) | 70 (651 035) | 66 (3739) | 62 (3746) | 100 (1112) | 18 (118) | 100 (946) | 100 (87 847) |
| History of cerebrovascular disease | 30 (43 609) | 25 (232 250) | 29 (1643) | 23 (1412) | 7.1 (79) | 100 (654) | 2.7 (26) | 4.2 (3714) |
| History of peripheral artery disease | 15 (21 950) | 5.5 (51 605) | 22 (1262) | 24 (1441) | 9.0 (100) | 8.3 (54) | 3.8 (36) | 4.1 (3566) |
| History of abdominal aortic aneurysm | 2.7 (4009) | 4.9 (45 590) | - | - | - | - | 0.4 (4) | 1.3 (1118) |
| Years since first atherosclerotic CV disease diagnosis | - | 7 [3–13] | - | - | - | - | 1 [1–1] | 0 [0–0] |
| Use of antithrombotics | 87 (128 534) | 89 (833 445) | s | - | 99 (1101) | 98 (643) | 95 (900) | 97 (85 588) |
| Follow-up (years) | 6.1 [3.1–9.0] | 2.3 [2.3–2.3] | 12.0 [5.8–13.8] | 1.8 [1.3–2.1] | 7.0 [6.8–7.5] | 2.2 [1.8–2.6] | 5.0 [2.4–6.9] | 4.7 [1.9–8.2] |
| Rate of recurrent CV events/1000 PY* [95% CI] | 30 [30–30] | 26 [26–26] | 37 [35–38] | 26 [23–29] | 29 [25–34] | 60 [48–75] | 24 [19–29] | 31 [30–31] |
| Rate of non-CV death/1000 PY* [95% CI] | 27 [27–28] | 16 [15–16] | 20 [19–22] | 12 [10–15] | 6 [4–8] | 29 [21–40] | 7 [5–10] | 13 [12–13] |
| Karelia | Bialystok P/P |
Estonian Biobank | SURF Serbia | EUROASPIREV | REACH- EU | REACH non-EU |
Veterans Affairs | |
|---|---|---|---|---|---|---|---|---|
| Country | Finland | Poland | Estonia | Serbia | - | - | - | US |
| European risk region | Moderate risk | High risk | High risk | Very High risk | Low-very high | Low-very high | - | - |
| Number of patients | 3303 | 243 | 11 669 | 203 | 7044 | 18 100 | 28 407 | 930 725 |
| Age (years) | 70 ± 9 | 65 ± 9 | 65 [57–72] | 65 ± 9 | 64 ± 9 | 65 ± 9 | 68 ± 9 | 73 ± 10 |
| Male sex | 69 (2289) | 75 (182) | 42 (4909) | 70 (143) | 74 (5232) | 72 (13 046) | 67 (19 028) | 98 (912 063) |
| Current smoking | 22 (732) | 20 (48) | 15 (1768) | 30 (61) | 16 (1135) | 18 (3307) | 14 (4020) | 44 (404 454) |
| Systolic blood pressure (mmHg) | 141 [129–158] | 131 [121–146] | 135 [120–145] | 130 [120–140] | 132 [121–145] | 140 [130–152] | 130 [120–145] | 132 [120–142] |
| BMI (kg/m2) | 28 [25–31] | 29 [27–33] | 28 [25–32] | 27 [25–29] | 29 [26–32] | 27 [25–30] | 27 [24–31] | - |
| C-reactive protein (mg/L) | 1.8 [1.8–2.2] | 1.1 [0.5–2.5] | 2.4 [1.1–5.1] | 0.8 [0.5–1.8] | - | 2.1 [1.0–4.6] | 2.1 [1.0–4.7] | - |
| eGFR (mL/min/1.73 m2) | 79 [63–90] | 77 [65–90] | 77 [59–92] | 83 [67–92] | 79 [64–91] | 73 [59–87] | 71 [56–87] | 70 [54–83] |
| Total cholesterol (mmol/L) | 4.1 [3.3–5.1] | 4.0 [3.3–4.7] | 5.5 [4.7–6.3] | 4.4 [3.6–5.2] | 4.0 [3.4–4.8] | 5.2 [4.4–6.0] | 4.6 [4.0–5.4] | - |
| HDL cholesterol (mmol/L) | 1.2 [1.0–1.5] | 1.2 [1.1–1.6] | 1.3 [1.0–1.7] | 1.1 [0.9–1.2] | 1.1 [0.9–1.3] | 1.2 [1.0–1.5] | 1.2 [1.0–1.4] | - |
| LDL cholesterol (mmol/L) | 2.5 [1.8–3.3] | 2.0 [1.5–2.5] | 3.0 [2.4–3.9] | 2.7 [2.1–3.5] | 2.1 [1.7–2.8] | 3.1 [2.5–3.8] | 2.7 [2.1–3.3] | - |
| Triglycerides (mmol/L) | 1.3 [0.9–1.8] | 1.2 [0.8–1.8] | - | 1.1 [0.9–1.4] | 1.4 [1.0–1.9] | 1.6 [1.1–2.2] | 1.5 [1.1–2.2] | - |
| Diabetes mellitus | 30 (1004) | 31 (76) | 18 (2122) | 34 (70) | 30 (2098) | 32 (5749) | 42 (11 955) | 51 (470 804) |
| History of coronary artery disease | 91 (3016) | 74 (181) | 91 (10 571) | 100 (203) | 100 (7044) | 71 (12 871) | 73 (20 856) | 81 (751 706) |
| History of cerebrovascular disease | 6.8 (225) | 7.0 (17) | 9.9 (1151) | 3.4 (7) | 4.3 (306) | 33 (5951) | 33 (9385) | - |
| History of peripheral artery disease | 8.1 (269) | 9.1 (22) | 9.8 (1146) | 2.0 (4) | 2.9 (202) | 20 (3681) | 11 (3149) | 39 (362 064) |
| History of abdominal aortic aneurysm | 1.4 (47) | - | 0.6 (66) | 3.0 (6) | - | 3.0 (550) | 3.3 (930) | 1.4 (13 316) |
| Years since first atherosclerotic CV disease diagnosis | 0 [0–2] | 2 [1–4] | 5 [2–10] | 0 [0–2] | 2 [1–8] | 1 [0–11] | 1 [0–10] | 6 [2–12] |
| Use of antithrombotics | - | 96 (233) | - | 96 (195) | 96 (6776) | 70 (12 646) | 73 (20 831) | - |
| Follow-up (years) | 2.2 [1.0–3.5] | 2.8 [2.4–3.4] | 2.0 [0.4–9.1] | 3.9 [3.2–5.0] | 1.3 [1.1–1.6] | 1.8 [1.6–1.9] | 1.8 [1.6–1.9] | 3.5 [2.1–3.8] |
| Rate of recurrent CV events/1000 PY* [95% CI] | 43 [39–48] | 37 [24–56] | 64 [62–67] | 59 [44–79] | 26 [23–30] | 63 [60–66] | 50 [48–52] | 100 [100–100] |
| Rate of non-CV death/1000 PY* [95% CI] | 20 [17–24] | 17 [9–31] | 10 [9–11] | 3 [0–9] | 4 [2–5] | 13 [12–15] | 14 [13–15] | 23 [23–23] |
Data are presented as % (n), mean ± standard deviation, median [25th–75th percentile] as appropriate.
SBP, systolic blood pressure: BMI, body mass index; CI, confidence interval; CRP, C-reactive protein; eGFR, estimated glomerular filtration rate; HDL, high-density lipoprotein; LDL, low-density lipoprotein; CV, cardiovascular; PY, person-years; EU, Europe.
The event rate was estimated based on the total follow-up time and all events in the cohort adjusted for competing risks (i.e. the event rate for non-CV death may be higher; however, the model is adjusted for competing risks.