Cardiovascular risk assessment based on SCORE and SCORE2

Abstract

Introduction:The 2021 European Society of Cardiology (ESC) guidelines on cardiovascular disease prevention introduced significant changes compared to the previous 2016 edition. Particular attention should be paid to the stepwise approach to treating patients with cardiovascular risk factors, based on individual risk stratification. The SCORE scale previously recommended for risk assessment and its Polish adaptation Pol-SCORE have been replaced by SCORE2 and SCORE2-OP in the latest guidelines.The aim of the study: The aim of this study is a parallel cardiovascular risk assessment with Pol-SCORE and SCORE2 in the same patient population.Material and methods: The study included 159 patients aged 40 to 70 years without prior cardiovascular events that were diagnosed with hypertension or hypercholesterolemia between 6 and 24 months before the start of the study. Patients with diabetes mellitus, chronic kidney disease, and familial hypercholesterolemia were excluded from the study. Results:The 10-year risk of cardiovascular event (SCORE2) was twice as high as the risk of cardiovascular death (Pol-SCORE). In the Pol-SCORE scale, most patients were at moderate risk (65.41%), while based in the SCORE2 scale the dominant group was in the low-to-moderate risk category (49.06%). Among the patients with moderate risk of cardiovascular death (Pol-SCORE), low-to-moderate, high, and very high CVD risk groups (SCORE2) were reported. In other cases, the risk assessments of cardiovascular death and cardiovascular event appear to be consistent. This observation is confirmed by the strong positive correlation (R = 0.7493; p < 0.0001) between the Pol-SCORE and SCORE2 scales.Conclusions: Cardiovascular risk assessments based on the SCORE and SCORE2 scales are broadly consistent, but in individual cases, the results fall into radically different risk categories.