- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00006514
Multivariate Risk of CVD in Diverse Populations
Study Overview
Status
Conditions
Detailed Description
BACKGROUND:
Several algorithms have been developed to calculate multivariate risk of CVD based on characteristics associated with the disease. Framingham Heart Study data were used to develop the original algorithms, along with later models, using different mathematical forms, outcomes, and characteristics. Researchers then began to investigate the issue of generalizability, whether these risk estimates could be applied to new populations. For these algorithms to have general application, they must be able to rank risk correctly. And, when Framingham models were compared to new models developed for other studies, resulting orderings of risk were, in fact, similar.
The ability to order risk correctly, however, does not imply that estimated probabilities are right in terms of predicting disease for individuals. Methods are needed to assess individual risk to make treatment decisions, do cost-benefit analyses, and quantify benefits. These methods must be based on the patient's absolute risk, and existing equations may be incapable of establishing absolute risk across populations.
Earlier comparisons of multivariate risk among studies have made comparison populations as homogenous as possible before analysis. However, if multivariate risk estimates are to be truly useful, they must be applicable to the general population, and to be applicable, estimates must be based on comparisons of cohorts that include women and ethnic minorities. Also, in statistical terms, estimates must be robust enough to allow for minor shifts in methodologies for data collection and endpoint definition.
DESIGN NARRATIVE:
The heterogeneity of multivariate risk in different populations was examined based on data from studies representing national samples, cohort studies, and clinical trials. An analysis of these studies was conducted that included both sexes, various risk profiles, and representatives from several nationalities and ethnic groups. The pooled sample involved 20 studies, 233,833 participants, and over 47,000 deaths. Based on a common statistical approach, proportional hazards models were developed for each study to relate a set of essential characteristics to the prediction of CVD mortality. The characteristics included body mass index, age, blood pressure, serum cholesterol, smoking, and diabetes status. The models were then compared in terms of their ability to predict absolute risk of mortality across studies.
Secondary analyses were conducted to discover factors associated with inaccurate prediction and study characteristics associated with particular findings, such as interaction terms. An empirical examination was conducted of methods for adding newly discovered risk factors to existing prediction equations.
The study completion date listed in this record was obtained from the "End Date" entered in the Protocol Registration and Results System (PRS) record.
Study Type
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Study Plan
How is the study designed?
Collaborators and Investigators
Investigators
- Daniel McGee, Florida State University
Publications and helpful links
General Publications
- Natarajan S, Liao Y, Cao G, Lipsitz SR, McGee DL. Sex differences in risk for coronary heart disease mortality associated with diabetes and established coronary heart disease. Arch Intern Med. 2003 Jul 28;163(14):1735-40. doi: 10.1001/archinte.163.14.1735.
- Diverse Populations Collaboration. Smoking, body weight, and CHD mortality in diverse populations. Prev Med. 2004 Jun;38(6):834-40. doi: 10.1016/j.ypmed.2003.12.022.
- Natarajan S, Liao Y, Sinha D, Cao G, McGee DL, Lipsitz SR. Sex differences in the effect of diabetes duration on coronary heart disease mortality. Arch Intern Med. 2005 Feb 28;165(4):430-5. doi: 10.1001/archinte.165.4.430.
Study record dates
Study Major Dates
Study Start
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 950 (Duke)
- R01HL067460 (U.S. NIH Grant/Contract)
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Heart Diseases
-
Baker Heart and Diabetes InstitutePrincess Alexandra Hospital, Brisbane, Australia; Royal Perth Hospital; Alice... and other collaboratorsRecruitingHeart Failure | Valve Heart DiseaseAustralia
-
Medical University of ViennaUnknownHeart Diseases | Heart Failure | Valvular Heart DiseaseAustria
-
Centre Chirurgical Marie LannelongueActive, not recruitingValvular Heart Disease | Valve Disease, Heart
-
Abiomed Inc.RecruitingHeart Diseases | Acute Decompensated Heart Failure | Congestive Heart Failure | Acute Heart FailureUnited States
-
Wuerzburg University HospitalRecruitingHeart Failure | Chronic Heart Failure | Chronic Heart DiseaseGermany
-
Aristotle University Of ThessalonikiRecruitingCardiovascular Diseases | Heart Failure | Valvular Heart Disease | Biochemical DysfunctionGreece
-
Kathirvel SubramaniamUniversity of Maryland, Baltimore; CSL BehringRecruitingHeart Failure,Congestive | Heart Disease End StageUnited States
-
University of MichiganTerminatedDiastolic Heart Failure | Hypertensive Heart DiseaseUnited States
-
Wake Forest UniversityNational Institute on Aging (NIA)CompletedHeart Failure, Congestive | Diastolic Heart FailureUnited States
-
University College, LondonBritish Heart Foundation; Horizon 2020 - European CommissionRecruitingValvular Heart DiseaseUnited Kingdom