Leisure-time physical activity does not boost CV risk predic
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Adding leisure-time physical activity level did not improve the risk prediction performance of the American Heart Association/American College of Cardiology Pooled Cohort equations, researchers reported.

The American Heart Association/American College of Cardiology pooled cohort equations (PCEs) are used for predicting 10-year atherosclerotic cardiovascular disease (ASCVD) risk. Pooled cohort equation risk prediction capabilities across self-reported leisure-time physical activity (LTPA) levels and the change in model performance with addition of LTPA to the PCE are unclear.

This study aimed to evaluate PCE risk prediction performance across self-reported LTPA levels and the change in model performance by adding LTPA to the existing PCE model.

Individual-level pooling of data from 3 longitudinal cohort studies—Atherosclerosis Risk in Communities, Multi-Ethnic Study of Atherosclerosis, and Cardiovascular Health Study—was performed. A total of 18?824 participants were stratified into 4 groups based on self-reported LTPA levels: inactive (0 metabolic equivalent of task [MET]-min/wk), less than guideline-recommended (less than 500 MET-min/wk), guideline-recommended (500-1000 MET-min/week), and greater than guideline-recommended (more than 1000 MET-min/wk).

Pooled cohort equation risk discrimination was studied using the C statistic and reclassification capabilities were studied using the Greenwood Nam-D’Agostino X2 goodness-of-fit test. Change in risk discrimination and reclassification on adding LTPA to PCEs was evaluated using change in C statistic, integrated discrimination index, and categorical net reclassification index.

Results:
-- Among 18 824 participants studied, 10 302 were women (54.7%); mean (SD) age was 57.6 (8.2) years.

-- A total of 5868 participants (31.2%) were inactive, 3849 (20.4%) had less than guideline-recommended LTPA, 3372 (17.9%) had guideline-recommended LTPA, and 5735 (30.5%) had greater than guideline-recommended LTPA level.

-- Higher LTPA levels were associated with a lower risk of ASCVD after adjustment for risk factors.

-- Across LTPA groups, PCE risk discrimination and risk calibration was similar.

-- Addition of LTPA to the PCE model resulted in no significant change in the C statistic and categorical net reclassification index, but a minimal improvement in the integrated discrimination index was observed.

-- Similar results were noted when cohort-specific coefficients were used for creating the baseline model.

Conclusively, higher self-reported LTPA levels appear to be associated with lower ASCVD risk and increasing LTPA promotes cardiovascular wellness. These findings suggest the American Heart Association/American College of Cardiology PCEs are accurate at estimating the probability of 10-year ASCVD risk regardless of LTPA level. The addition of self-reported LTPA to PCEs does not appear to be associated with improvement in risk prediction model performance.

Source: https://jamanetwork.com/journals/jamacardiology/article-abstract/2779383?resultClick=1
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