Rachel Rivera

Rachel, a sophomore studying Biophysics and Biochemistry at Yale University, recalibrated an atherosclerotic cardiovascular disease risk prediction model.

Contemporary atherosclerotic cardiovascular disease (ASCVD) risk prediction frameworks estimate long-term events risk and guide clinical decisions. BSRP has been a transformative experience. Every faculty member I met at the Broad is excited about their research and impacting their community. I will forever cherish the community of friends and colleagues I have made this summer at the Broad. Prior literature has reported suboptimal calibration of the 2013 Pooled Cohort Equations (PCE) in external population-based cohorts. We recalibrated the PCE to tailor prediction in a US healthcare biobank and reassessed its performance. We identified 62,316 participants aged 40 to 79 years and without prior ASCVD or lipid-lowering medications from the Mass General Brigham Biobank—a volunteer cohort of New England healthcare sites. The PCE was recalibrated using sex- and race-specific baseline survival and risk factors distributions of the Mass General Brigham Biobank. The original PCE consistently underestimated ASCVD risk across all risk categories, whereas the recalibrated PCE overestimated risk specifically in the high-risk predicted 10-year ASCVD risk group. Recalibration did not improve discrimination. At the 7.5% treatment threshold, the recalibrated PCE correctly upclassified 33.8% among participants who underwent ASCVD event. In summary, the PCE's recalibration may help guide appropriate cardiovascular interventions in healthcare-based populations.

Project: Recalibration of the Pooled Cohort Risk Equations for Cardiovascular Risk Prediction in a New England-based Healthcare Biobank

Mentors: So Mi Jemma Cho

PI: Natarajan Lab