Publication
SCORE2 risk prediction algorithms: new models to estimate 10-year risk of cardiovascular disease in Europe
Publisher:
Oxford University Press (OUP)
Date:
13-06-2021
DOI:
10.1093/EURHEARTJ/EHAB309
Abstract: 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 in iduals without previous CVD or diabetes aged 40–69 years in Europe. We derived risk prediction models using in idual-participant data from 45 cohorts in 13 countries (677 684 in iduals, 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 in iduals. For external validation, we analysed data from 25 additional cohorts in 15 European countries (1 133 181 in iduals, 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 ex le, 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. SCORE2—a new algorithm derived, calibrated, and validated to predict 10-year risk of first-onset CVD in European populations—enhances the identification of in iduals at higher risk of developing CVD across Europe.