Validity of Cardiovascular Risk Prediction Models in Kidney Transplant Recipients
Background. Predicting cardiovascular risk is of great interest in renal transplant recipients since cardiovascular disease is the leading cause of mortality. Objective. To conduct a systematic review to assess the validity of cardiovascular risk prediction models in this population. Methods. Five d...
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Wiley
2014-01-01
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| Series: | The Scientific World Journal |
| Online Access: | http://dx.doi.org/10.1155/2014/750579 |
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| author | Holly Mansell Samuel Alan Stewart Ahmed Shoker |
| author_facet | Holly Mansell Samuel Alan Stewart Ahmed Shoker |
| author_sort | Holly Mansell |
| collection | DOAJ |
| description | Background. Predicting cardiovascular risk is of great interest in renal transplant recipients since cardiovascular disease is the leading cause of mortality. Objective. To conduct a systematic review to assess the validity of cardiovascular risk prediction models in this population. Methods. Five databases were searched (MEDLINE, EMBASE, SCOPUS, CINAHL, and Web of Science) and cohort studies with at least one year of follow-up were included. Variables that described population characteristics, study design, and prognostic performance were extracted. The Quality in Prognostic Studies (QUIPS) tool was used to evaluate bias. Results. Seven studies met the criteria for inclusion, of which, five investigated the Framingham risk score and three used a transplant-specific model. Sample sizes ranged from 344 to 23,575, and three studies lacked sufficient event rates to confidently reach conclusion. Four studies reported discrimination (as measured by c-statistic), which ranged from 0.701 to 0.75, while only one risk model was both internally and externally validated. Conclusion. The Framingham has underestimated cardiovascular events in renal transplant recipients, but these studies have not been robust. A risk prediction model has been externally validated at least on one occasion, but comprehensive validation in multiple cohorts and impact analysis are recommended before widespread clinical application is advocated. |
| format | Article |
| id | doaj-art-dc0127430ed540d885d698b9eb4d5cea |
| institution | Kabale University |
| issn | 2356-6140 1537-744X |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Scientific World Journal |
| spelling | doaj-art-dc0127430ed540d885d698b9eb4d5cea2025-02-03T00:59:57ZengWileyThe Scientific World Journal2356-61401537-744X2014-01-01201410.1155/2014/750579750579Validity of Cardiovascular Risk Prediction Models in Kidney Transplant RecipientsHolly Mansell0Samuel Alan Stewart1Ahmed Shoker2College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, S7N 5E5, CanadaDepartment of Medicine, University of Saskatchewan, Saskatoon, SK, S7N 5E5, CanadaDepartment of Medicine, Division of Nephrology, College of Medicine, University of Saskatchewan, Saskatoon, SK, S7N 5E5, CanadaBackground. Predicting cardiovascular risk is of great interest in renal transplant recipients since cardiovascular disease is the leading cause of mortality. Objective. To conduct a systematic review to assess the validity of cardiovascular risk prediction models in this population. Methods. Five databases were searched (MEDLINE, EMBASE, SCOPUS, CINAHL, and Web of Science) and cohort studies with at least one year of follow-up were included. Variables that described population characteristics, study design, and prognostic performance were extracted. The Quality in Prognostic Studies (QUIPS) tool was used to evaluate bias. Results. Seven studies met the criteria for inclusion, of which, five investigated the Framingham risk score and three used a transplant-specific model. Sample sizes ranged from 344 to 23,575, and three studies lacked sufficient event rates to confidently reach conclusion. Four studies reported discrimination (as measured by c-statistic), which ranged from 0.701 to 0.75, while only one risk model was both internally and externally validated. Conclusion. The Framingham has underestimated cardiovascular events in renal transplant recipients, but these studies have not been robust. A risk prediction model has been externally validated at least on one occasion, but comprehensive validation in multiple cohorts and impact analysis are recommended before widespread clinical application is advocated.http://dx.doi.org/10.1155/2014/750579 |
| spellingShingle | Holly Mansell Samuel Alan Stewart Ahmed Shoker Validity of Cardiovascular Risk Prediction Models in Kidney Transplant Recipients The Scientific World Journal |
| title | Validity of Cardiovascular Risk Prediction Models in Kidney Transplant Recipients |
| title_full | Validity of Cardiovascular Risk Prediction Models in Kidney Transplant Recipients |
| title_fullStr | Validity of Cardiovascular Risk Prediction Models in Kidney Transplant Recipients |
| title_full_unstemmed | Validity of Cardiovascular Risk Prediction Models in Kidney Transplant Recipients |
| title_short | Validity of Cardiovascular Risk Prediction Models in Kidney Transplant Recipients |
| title_sort | validity of cardiovascular risk prediction models in kidney transplant recipients |
| url | http://dx.doi.org/10.1155/2014/750579 |
| work_keys_str_mv | AT hollymansell validityofcardiovascularriskpredictionmodelsinkidneytransplantrecipients AT samuelalanstewart validityofcardiovascularriskpredictionmodelsinkidneytransplantrecipients AT ahmedshoker validityofcardiovascularriskpredictionmodelsinkidneytransplantrecipients |