{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T04:08:41Z","timestamp":1789013321145,"version":"build-2803163510"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"15","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,8,4]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Ten\u2010year atherosclerotic cardiovascular disease (ASCVD) risk prediction models include the pooled cohort equations (PCE) and the Predicting Risk of Cardiovascular Disease Events (PREVENT) models. We evaluated the relative contributions of predictors in these models, along with social determinants and emerging biomarkers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We pooled data from 13\u2009108 participants (58.4% female, 22.6% Black participants, median age 61\u2009years) across 3 prospective cohorts: ARIC (Atherosclerosis Risk in Communities), FOS (Framingham Offspring Study), and MESA (Multi\u2010Ethnic Study of Atherosclerosis). Of these participants, 873 (6.7%) developed ASCVD within 10\u2009years. Candidate predictors included variables from PCE and PREVENT\u2010ASCVD, alongside small dense low\u2010density lipoprotein cholesterol, hs\u2010CRP (high\u2010sensitivity C\u2010reactive protein), lipoprotein(a), and education level. We fit Cox proportional hazards models and applied stepwise selection, elastic net, and random forest for variable selection. Selected predictors were integrated into an exploratory model, Expanded ASCVD Non\u2010traditional Determinants (EXPAND), which was compared with PCE and PREVENT\u2010ASCVD both as originally published and after refitting in our sample.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Most predictors shared by PCE and PREVENT\u2010ASCVD were selected across methods; small dense low\u2010density lipoprotein cholesterol, hs\u2010CRP, and education were also selected, whereas self\u2010reported race was not. Using published coefficients, PCE overestimated 10\u2010year ASCVD risk, whereas PREVENT\u2010ASCVD underestimated risk. Compared with PCE and PREVENT\u2010ASCVD models refitted in our sample, EXPAND showed modest calibration advantages, particularly among Black men, and consistently achieved higher C\u2010statistics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">In our sample, self\u2010reported race did not improve ASCVD risk prediction, whereas small dense low\u2010density lipoprotein cholesterol, hs\u2010CRP, and education level added predictive value, suggesting potential utility in including additional biomarkers and social factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.049726","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T11:20:02Z","timestamp":1785496802000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Comprehensive Evaluation of Atherosclerotic Cardiovascular Disease Risk Predictors Across the Pooled Cohort Equations, Predicting Risk of Cardiovascular Disease Events, and an Expanded Model"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2528-4624","authenticated-orcid":false,"given":"Yixin","family":"Zhang","sequence":"first","affiliation":[{"name":"Boston University School of Public Health","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7158-3085","authenticated-orcid":false,"given":"Ernst J.","family":"Schaefer","sequence":"additional","affiliation":[{"name":"Tufts University School of 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