An increase in the GAPSS during the followup was associated with a higher risk of vascular events ( relative risk 12.30 [ 95 % confidence interval ( 95 % CI ) 1.43-106 .13 ] , P = 0.004 ) , and an increase of more than 3 points showed the best risk accuracy for vascular events ( hazard ratio 48 [ 95 % CI 6.90-333 .85 ] , P = 0.0001 ) .