Validation and modification of the AFHCHDC7 risk score for predicting the long-term cardiovascular disease risk after the Great East Japan Earthquake: The Fukushima Health Management Survey

Objectives: This study aimed to evaluate the predictive performance of the AFHCHDC7 risk score, developed for post-disaster cardiovascular disease (CVD) risk management, for 6-year CVD risk in Fukushima Prefecture after the Great East Japan Earthquake compared to the Suita CVD risk score and to modify the AFHCHDC7 risk score.Methods: The present study comprised 14,779 individuals aged 30-79 years with no history of CVD at baseline who underwent the comprehensive health checkup and completed the mental health and lifestyle survey in 2011. Its primary outcome was CVD onset (myocardial infarction, stroke). Logistic regression analyses were used to construct a prediction model. The calibration performance and discrimination performance according to area under the curve (AUC) values were evaluated for each model.Results: The AFHCHDC7 risk score had lower AUC values than the Suita CVD risk score from baseline for 6 years (AUC: 0.65). The modified AFHCHDC7 risk score (age-stratified, adding sex and smoking) had higher predictive performance than the Suita CVD risk score from base-line for 6 years (AUC: 0.74 vs. 0.73).Conclusions: The modified AFHCHDC7 score may be useful as a simple tool for identifying individuals' long-term CVD risk in disaster evacuees. The utility of this score needs to be carefully evaluated in future studies.