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 -