Receiver Operating Characteristic Curve For Prediction Research Articles

Correction: Risk Factors for Coronary Heart Disease in Men 18 to 39 Years of Age

Corrections3 July 2001Correction: Risk Factors for Coronary Heart Disease in Men 18 to 39 Years of AgeFREESearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-135-1-200107030-00042 SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In a recent article on risk factors for coronary heart disease in 18- to 39-year-old men (1), the first line of the figure legend should read “Receiver-operating characteristic curves for prediction of fatal coronary heart disease in young men over 20 years,” not “Receiver-operating characteristic curves … in young men older than 20 years of age.”Reference1. Navas-Nacher EL, Colangelo L, Beam C, Greenland P. Risk factors for coronary heart disease in men 18 to 39 years of age. Ann Intern Med. 2001;134:433-9. [PMID: 11255518] LinkGoogle Scholar Comments0 CommentsSign In to Submit A Comment Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRisk Factors for Coronary Heart Disease in Men 18 to 39 Years of Age Elena L. Navas-Nacher , Laura Colangelo , Craig Beam , and Philip Greenland Metrics 3 July 2001Volume 135, Issue 1Page: 71KeywordsCoronary heart diseaseMedical risk factors ePublished: 3 July 2001 Issue Published: 3 July 2001 Copyright & PermissionsCopyright © 2001 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

Respiratory muscle dysfunction in congestive heart failure: clinical correlation and prognostic significance.

In congestive heart failure (CHF), the prognostic significance of impaired respiratory muscle strength has not been established. Maximal inspiratory pressure (Pi(max)) was prospectively determined in 244 consecutive patients (207 men) with CHF (ischemic, n=75; idiopathic dilated cardiomyopathy, n=169; age, 54+/-11 years; left ventricular ejection fraction [LVEF], 22+/-10%). Pi(max) was lower in the 244 patients with CHF than in 25 control subjects (7.6+/-3.3 versus 10.5+/-3.7 kPa; P=0.001). The 57 patients (23%) who died during follow-up (23+/-16 months; range, 1 to 48 months) had an even more reduced Pi(max) (6.3+/-3.2 versus 8.1+/-3.2 kPa in survivors; P=0.001). Kaplan-Meier survival curves differentiated between patients subdivided according to quartiles for Pi(max) (P=0.014). Pi(max) was a strong risk predictor in both univariate (P=0.001) and multivariate Cox proportional hazard analyses (P=0.03); multivariate analyses also included NYHA functional class, LVEF, peak oxygen consumption (peak VO(2)), and norepinephrine plasma concentration. The areas under the receiver-operating characteristic curves for prediction of 1-year survival were comparable for Pi(max) and peak VO(2) (area under the curve [AUC], 0.68 versus 0.73; P=0.28), and they improved with the triple combination of Pi(max), peak VO(2), and LVEF (AUC, 0.82; P=0.004 compared with AUC of Pi(max)). In patients with CHF, inspiratory muscle strength is reduced and emerges as a novel, independent predictor of prognosis. Because testing for Pi(max) is simple in clinical practice, it might serve as an additional factor to improve risk stratification and patient selection for cardiac transplantation.

Use of electron beam tomography data to develop models for prediction of hard coronary events

Background Prediction of hard cardiac events (myocardial infarction and coronary death) remains difficult in spite of the identification of several relevant risk factors for the development of coronary artery disease (CAD). New indicators of risk might add to our predictive ability. We used measures of coronary artery calcification (CAC) found by electron beam tomography (EBT) imaging to develop prediction models for hard cardiac events alone and in association with traditional risk factors for CAD. Methods Two groups of patients were studied: group A, 676 asymptomatic patients (mean age 52 years, 51% men) prospectively followed up for 32 ± 7 months after being referred by primary care physicians for a screening EBT, and group B, 10,122 asymptomatic patients screened by EBT at one center and used as controls for calculation of calcium score nomograms. Results The occurrence of hard events in group A patients was related to traditional risk factors for CAD, presence of CAC (score >0), Ln (1 + absolute calcium score [CS]), and age- and sex-specific CS percentiles (CS%). Univariate analyses showed that age, smoking, diabetes mellitus, presence of CAC, Ln (1 + absolute CS), and CS% were predictive of hard events (all P <.05). Multiple logistic regression analyses demonstrated that CS% was the only significant predictor of events and provided incremental prognostic value when added to traditional risk factors for CAD (chi-square, P <.001). In a comparison of receiver-operator characteristic curves for prediction of hard events, the area under the curve for CS% plus conventional risk factors and age was significantly larger than that obtained by use of traditional risk factors and age separately as predictors (0.84 vs 0.71, respectively, P <.001). Furthermore, the area under the curve of CS% alone was significantly larger than that of traditional risk factors and age combined (0.82 vs 0.71, P =.028). Conclusions Patients are usually selected for EBT screening on the basis of the presence of conventional risk factors for CAD. However, an age- and sex-specific calcium score provides the best predictive model for the occurrence of hard coronary events and adds incremental prognostic information to conventional risk factors for CAD. (Am Heart J 2001;141:375-82.)