NEW equations, named AROSE, have been developed to better predict the 10-year risk of atherosclerotic cardiovascular disease (ASCVD) in individuals with obesity, outperforming existing models.
ASCVD is a major public health concern, especially in individuals with obesity, who are inadequately assessed by current risk prediction models. This study aimed to create and validate equations tailored to predict ASCVD risk specifically in populations with obesity. The research leverages data from the ARIC (Atherosclerosis Risk In Communities) study and the MESA (Multi-Ethnic Study of Atherosclerosis) cohort, focusing on improving prediction accuracy in this at-risk group.
The study developed gender-specific equations using data from 3,058 individuals in ARIC and validated them in a cohort of 1,953 individuals in MESA. The newly created AROSE models were compared to the 2008 Framingham Risk Score (FRS) and pooled cohort equations (PCEs). In the ARIC cohort, AROSE demonstrated strong predictive ability, with C-statistics of 0.758 for men and 0.817 for women, showing excellent discrimination and calibration (P > 0.05 for both genders). In the MESA validation cohort, AROSE maintained its superiority, achieving C-statistics of 0.707 for men and 0.734 for women. These figures exceeded those for PCEs and FRS. Furthermore, AROSE showed significant improvements in net reclassification and greater clinical decision-making benefits when compared to the other models.
The study concluded that AROSE provides a more accurate assessment of ASCVD risk in individuals with obesity compared to PCEs and FRS. This improved accuracy could guide clinicians in making more precise treatment decisions for this population. Future work should focus on integrating AROSE into clinical practice and evaluating its real-world utility across diverse populations with obesity. Long-term, these equations could contribute to personalised care approaches, reducing ASCVD incidence in a high-risk demographic.
Katrina Thornber, EMJ
Reference
Zhou Y et al. Equations for predicting the 10-year risk of atherosclerotic cardiovascular disease in population with obesity. JACC Adv. 2025;4(2):101542.
