D uring the past decades, cardiovascular disease (CVD) has rapidly increased in Asian countries and about half of the worldwide burden of CVD is carried in these countries. 1,2 Therefore, CVD prevention in Asia has been an important issue for world health. 3 In the guideline, tailored approaches by risk stratification of asymptomatic people using global risk scores have become an accepted method for the primary prevention of CVD. 4,5 However, effectiveness of existing CVD risk models, developed

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... on the basis of the database of Western countries, was rarely validated for Asian populations. 6 In addition, a risk prediction model, considering the race or ethnic differences of risk factors attributable to development of CVD in Asian populations, is limited. 3, 7 Atherosclerotic disease is rarely confined to the coronary arteries and thus the CVD risk factors are largely the same as those for coronary heart disease (CHD). 8 In addition to the standard Framingham risk factors of age, sex, diabetes mellitus, smoking, blood pressure, and cholesterol, 9,10 recently developed prediction models showed that CVD risk also relates to parental history of myocardial infarction (MI), inflammatory biomarkers, such as high-sensitivity C-reactive protein (hsCRP), and markers of glycemic control such as Background-A model for predicting cardiovascular disease in Asian populations is limited. Methods and Results-In total, 57 393 consecutive asymptomatic Korean individuals aged 30 to 80 years without a prior history of cardiovascular disease who underwent a general health examination were enrolled. Subjects were randomly classified into the train (n=45 914) and validation (n=11 479) cohorts. Thirty-one possible risk factors were assessed. The cardiovascular event was a composite of cardiovascular death, myocardial infarction, and stroke. In the train cohort, the C-index (95% confidence interval) and Akaike Information Criterion were used to develop the best-fitting prediction model. In the validation cohort, the predicted versus the observed cardiovascular event rates were compared by the C-index and Nam and D'Agostino χ 2 statistics. During a median follow-up period of 3.1 (interquartile range, 1.9-4.3) years, 458 subjects had 474 cardiovascular events. In the train cohort, the best-fitting model consisted of age, diabetes mellitus, hypertension, current smoking, family history of coronary heart disease, white blood cell, creatinine, glycohemoglobin, atrial fibrillation, blood pressure, and cholesterol ( C-index =0.757 [0.726-0.788] and Akaike Information Criterion =7207). When this model was tested in the validation cohort, it performed well in terms of discrimination and calibration abilities (C-index=0.760 [0.693-0.828] and Nam and D'Agostino χ 2 statistic =0.001 for 3 years; C-index=0.782 [0.719-0.846] and Nam and D'Agostino χ 2 statistic=1.037 for 5 years). Conclusions-A risk model based on traditional clinical and biomarkers has a feasible model performance in predicting cardiovascular events in an asymptomatic Korean population. (Circ Cardiovasc Qual Outcomes. 2014;7:944-951.)