Kaiser Questions Heart Attack Model

Kaiser Permanente researchers have questioned a widely used tool to predict the risk of individuals suffering heart attacks.

A new study undertaken by Kaiser researchers claim that the American College of Cardiology and American Heart Association Pooled Cohort, which was developed and released three years ago to predict the five-year risk of serious events among patients with atherosclerosis, severely overestimates actual risks among patients.

The study followed nearly 308,000 individuals in various ethnic groups 40 to 75 years old, from 2008 through 2013. The group did not have diabetes, prior heart disease or use of statins.

“Our study provides critical evidence to support recalibration of the risk equation in ‘real world’ populations, especially given the individual and public health implications of the widespread application of this risk calculator,” said Alan S. Go, M.D., chief of cardiovascular and metabolic conditions and research at the Kaiser's Northern California division of research.

According to the study, those patients who had a predicted risk of an adverse cardiac event of 2.5%, had an actual incidence rate of 0.2%. For those with a predicted risk of 3.75% and 4.99%, the actual incidence rate was 0.9%. For those with a risk above 5%, the actual incidence rate was 1.85%.

“From a relative standpoint, the overestimation is approximately five- to six-fold,” Go said. “Translating this, it would mean that we would be over-treating a good many people based on the risk calculator.” 

The study did find that the risk prediction model was much closer for individuals with diabetes who did not receive treatment with statins.