Abstract 14470: Recalibration of the ACC/AHA ASCVD Risk Estimator for Primary Prevention in a Large, Multiethnic Community-Based Population

Introduction: While the 2013 ACC/AHA Pooled Cohort ASCVD Risk Estimator was an important advance in predicting risk of ASCVD events, several studies have demonstrated suboptimal accuracy and calibration in more contemporary populations. We recalibrated the ACC/AHA ASCVD Risk Estimator in a large, ethnically diverse community-based population to improve identification of adults who may benefit from primary prevention strategies. Methods: Within Kaiser Permanente Northern California, we identified 310,165 members age 40-75 years in 2008 who had LDL-C 70 to 189 mg/dL, no known ASCVD or lipid-lowering therapy and complete 5-year follow-up. Non-fatal and fatal ASCVD events through 2013 were ascertained from electronic health records and death certificates using validated algorithms. Using split-sample derivation and validation, we applied similar methods used to develop the ACC/AHA ASCVD Risk Estimator but re-weighted the variables (age, treated and untreated systolic blood pressure, HDL-C, total cholesterol, ...