Validation of the Pooled Cohort Risk Equations from Recent ACC/AHA Guidelines

Recent American College of Cardiology/American Heart Association (ACC/AHA) guidelines for the assessment of cardiovascular risk recommend a new 10-year atherosclerotic cardiovascular disease (CVD) risk prediction tool called the Pooled Cohort risk equation. This new predictive model developed from cohorts of patients that were largely studied prior to the year 2000. In light of the declining CVD incidence since 2000, the external validity of the Pooled Cohort risk equation has been questioned. The present study sought to validate the Pooled Cohort equation in a contemporary cohort of 10,997 individuals aged 45–79 years without a prior history of atherosclerotic CVD for whom the guidelines would recommend consideration of a statin. In 47,481 person-years of follow-up, 192 coronary heart disease events and 146 strokes were observed. Differences in observed and predicted risk were small in patients for whom a statin …