SCORE2 risk prediction algorithms: new models to estimate 10-year risk of cardiovascular disease in Europe

Abstract

Aims The aim of this study was to develop, validate, and illustrate an updated prediction model (SCORE2) to estimate 10-year fatal and non-fatal cardiovascular disease (CVD) risk in individuals without previous CVD or diabetes aged 40–69 years in Europe. Methods and results We derived risk prediction models using individual-participant data from 45 cohorts in 13 countries (677 684 individuals, 30 121 CVD events). We used sex-specific and competing risk-adjusted models, including age, smoking status, systolic blood pressure, and total- and HDL-cholesterol. We defined four risk regions in Europe according to country-specific CVD mortality, recalibrating models to each region using expected incidences and risk factor distributions. Region-specific incidence was estimated using CVD mortality and incidence data on 10 776 466 individuals. For external validation, we analysed data from 25 additional cohorts in 15 European countries (1 133 181 individuals, 43 492 CVD events). After applying the derived risk prediction models to external validation cohorts, C-indices ranged from 0.67 (0.65–0.68) to 0.81 (0.76–0.86). Predicted CVD risk varied several-fold across European regions. For example, the estimated 10-year CVD risk for a 50-year-old smoker, with a systolic blood pressure of 140 mmHg, total cholesterol of 5.5 mmol/L, and HDL-cholesterol of 1.3 mmol/L, ranged from 5.9% for men in low-risk countries to 14.0% for men in very high-risk countries, and from 4.2% for women in low-risk countries to 13.7% for women in very high-risk countries. Conclusion SCORE2—a new algorithm derived, calibrated, and validated to predict 10-year risk of first-onset CVD in European populations—enhances the identification of individuals at higher risk of developing CVD across Europe.

SCORE2 Assessment in the Calculation of Cardiovascular Risk in Patients with Rheumatoid Arthritis

“…Given these findings, it is clear that new and updated guidelines are needed. Interestingly, in 2021, a new algorithm, SCORE2 was derived, calibrated, and validated, then launched in an effort to predict the 10-year risk of first-onset CV disease in European populations [ 8 ]. This new calculator improves the identification of people at high risk of developing CV disease because SCORE2 has been recalibrated using the most contemporary and representative CVD rates available.…”

ESSE-RF study: epidemiology and public health promotion

“…Разработка более современных инструментов оценки риска является актуальной задачей: со временем профиль ФР в популяции меняется, появляются новые факторы и происходит перераспределение вклада отдельных факторов в общий риск развития заболеваний. Не случайно, на замену шкалы SCORE (Systematic COronary Risk Evaluation), разработанной на когортах, набранных до 1986г, приходит новая шкала SCORE2, которая опубликована в июне 2021г [22] и включает не только фатальные сердечно-сосудистые события, как ее предшественница, но и нефатальные осложнения и представлена в виде 4-х таблиц риска (ранее было две). Что касается российских данных, то в шкалу были включены только данные исследования HAPPIEE (Health, Alcohol and Psychosocial factors In Eastern Europe), в котором проводилось проспективное наблюдение когорты жителей одного города РФ -Новосибирска, что вряд ли можно считать репрезентативным для всей страны.…”

Utility of family history in disease prediction in the era of polygenic scores

“…Family history is formally considered a risk enhancing factor for individuals with an intermediate estimated risk of ASCVD in the United States 23 . However, the Framingham score 24 , SCORE2 25 , and Pooled Cohort Equations (PCE) 26 do not incorporate family history to estimate 10-year atherosclerotic cardiovascular disease (ASCVD) risk 26 .…”