TY - JOUR

T1 - SCORE2 risk prediction algorithms

T2 - new models to estimate 10-year risk of cardiovascular disease in Europe

AU - Hageman, Steven

AU - Pennells, Lisa

AU - Ojeda, Francisco

AU - Kaptoge, Stephen

AU - Kuulasmaa, Kari

AU - de Vries, Tamar

AU - Xu, Zhe

AU - Kee, Frank

AU - Chung, Ryan

AU - Wood, Angela

AU - McEvoy, John William

AU - Veronesi, Giovanni

AU - Bolton, Thomas

AU - Dendale, Paul

AU - Ference, Brian A.

AU - Halle, Martin

AU - Timmis, Adam

AU - Vardas, Panos

AU - Danesh, John

AU - Graham, Ian

AU - Salomaa, Veikko

AU - Visseren, Frank

AU - De Bacquer, Dirk

AU - Blankenberg, Stefan

AU - Dorresteijn, Jannick

AU - Di Angelantonio, Emanuele

AU - Achenbach, Stephan

AU - Aleksandrova, Krasimira

AU - Amiano, Pilar

AU - Amouyel, Philippe

AU - Andersson, Jonas

AU - Bakker, Stephan J. L.

AU - Costa, Rui Bebiano Da Providencia

AU - Beulens, Joline W. J.

AU - Blaha, Michael

AU - Bobak, Martin

AU - Boer, Jolanda M. A.

AU - Bonet, Catalina

AU - Bonnet, Fabrice

AU - Boutron-Ruault, Marie-Christine

AU - Braaten, Tonje

AU - Brenner, Hermann

AU - Brunner, Fabian

AU - Brunner, Eric J.

AU - Brunstrom, Mattias

AU - Jørgensen, Torben

AU - Linneberg, Allan

AU - Overvad, Kim

AU - Tjønneland, Anne

AU - Tybjaerg-Hansen, Anne

AU - SCORE2 Working Grp

AU - ESC Cardiovasc Risk Collaboration

PY - 2021

Y1 - 2021

N2 - 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.

AB - 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.

KW - Risk prediction

KW - Cardiovascular disease

KW - Primary prevention

KW - 10-year CVD risk

KW - ACUTE CORONARY EVENTS

KW - PRIMARY-CARE

KW - PROFILE

KW - PARTICIPANTS

KW - VALIDATION

KW - RATIONALE

KW - DESIGN

U2 - 10.1093/eurheartj/ehab309

DO - 10.1093/eurheartj/ehab309

M3 - Journal article

C2 - 34120177

VL - 42

SP - 2439

EP - 2454

JO - European Heart Journal

JF - European Heart Journal

SN - 0195-668X

IS - 25

ER -