TY - JOUR
T1 - New Way to “SCORE” Risk
T2 - Updates on the ESC Scoring System and Incorporation into ESC Cardiovascular Prevention Guidelines
AU - Graham, Ian M.
AU - Di Angelantonio, Emanuele
AU - Huculeci, Radu
AU - Graham, Ian M.
AU - Di Angelantonio, Emanuele
AU - De Bacquer, Dirk
AU - Ference, Brian
AU - Halle, Martin
AU - Huculeci, Radu
AU - McEvoy, John
AU - Timmis, Adam
AU - Vardas, Panos
AU - Visseren, Frank
N1 - Funding Information:
Members of the Cardiovacular Risk Collaboration (CRC) Steering Committee are: Ian M Graham, Trinity College Dublin, Ireland | CRC Co-Chair. Emanuele Di Angelantonio, University of Cambridge, England | CRC Co-Chair. Dirk De Bacquer, Ghent University, Belgium. Brian Ference, University of Cambridge, England. John McEvoy, National University of Ireland, Ireland. Frank Visseren, University Medical Centre Utrecht, Netherlands. Martin Halle, University of Munich, Germany | European Association of Preventive Cardiology President 2020-2022. Radu Huculeci, ESC European Heart Health Institute (EHHI), Brussels, Belgium. Adam Timmis, William Harvey Research Institute, Queen Mary University London, England | EHHI Chair. Panos Vardas, University of Athens, Greece | EHHI Chief Strategy Officer.
Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2022/11
Y1 - 2022/11
N2 - Purpose of Review: Prior European Society of Cardiology (ESC) guidelines endorsed the SCORE 10-year cardiovascular disease (CVD) risk calculator to inform the total risk approach to CVD prevention, including the use of preventive interventions like lipid lowering therapies. However, SCORE was released in 2003, did not allow for estimation of fatal and non-fatal CVD events, and was limited to adults aged 40 to 70 years. The ESC’s Cardiovascular Risk Collaboration (CRC) was tasked with updating SCORE (SCORE2) and with extending the upper age range of adults eligible for risk estimation (SCORE2-OP). This review summarises these two deliverables. Recent Findings: Published in 2021, these updated risk scores allow for estimation of 10 year total (fatal + non-fatal) risks of a first atherosclerotic cardiovascular event in adults (SCORE2) and older persons (SCORE2-OP), calibrated for use in four European risk regions. The models account for competing risk of non-CVD death. These were extensively validated with excellent calibration and C-statistics ranging from 0.67 to 0.81. Summary: SCORE2 and SCORE2-OP have informed the 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. In addition to endorsing these two updated risk calculators, these guidelines have, for the first time, recommended the use of age-related risk categories. This change was motivated to prevent overreliance on age when making CVD prevention decisions.
AB - Purpose of Review: Prior European Society of Cardiology (ESC) guidelines endorsed the SCORE 10-year cardiovascular disease (CVD) risk calculator to inform the total risk approach to CVD prevention, including the use of preventive interventions like lipid lowering therapies. However, SCORE was released in 2003, did not allow for estimation of fatal and non-fatal CVD events, and was limited to adults aged 40 to 70 years. The ESC’s Cardiovascular Risk Collaboration (CRC) was tasked with updating SCORE (SCORE2) and with extending the upper age range of adults eligible for risk estimation (SCORE2-OP). This review summarises these two deliverables. Recent Findings: Published in 2021, these updated risk scores allow for estimation of 10 year total (fatal + non-fatal) risks of a first atherosclerotic cardiovascular event in adults (SCORE2) and older persons (SCORE2-OP), calibrated for use in four European risk regions. The models account for competing risk of non-CVD death. These were extensively validated with excellent calibration and C-statistics ranging from 0.67 to 0.81. Summary: SCORE2 and SCORE2-OP have informed the 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. In addition to endorsing these two updated risk calculators, these guidelines have, for the first time, recommended the use of age-related risk categories. This change was motivated to prevent overreliance on age when making CVD prevention decisions.
KW - Aged
KW - Aged, 80 and over
KW - Cardiovascular Diseases/prevention & control
KW - Humans
KW - Cardiovascular risk estimation
KW - Atherosclerotic cardiovascular disease (CVD) risk factors
UR - http://www.scopus.com/inward/record.url?scp=85142934603&partnerID=8YFLogxK
U2 - 10.1007/s11886-022-01790-6
DO - 10.1007/s11886-022-01790-6
M3 - Review article
C2 - 36441402
SN - 1523-3782
VL - 24
SP - 1679
EP - 1684
JO - Current cardiology reports
JF - Current cardiology reports
IS - 11
ER -