Risk prediction of cardiovascular disease in the Asia-Pacific region: The SCORE2 Asia-Pacific model

Noraidatulakma Abdullah, Muhammad Irfan Abdul Jalal, Elizabeth L.M. Barr, Parinya Chamnan, Chean Lin Chong, Lucky Cuenza, Pei Gao, Ian Graham, Saima Hilal, Joris Holtrop, Rahman Jamal, Tosha Ashish Kalhan, Hidehiro Kaneko, Chi Ho Lee, Charlie G.Y. Lim, Xiaofei Liu, Dianna J. Magliano, Nima Motamed, Maziar Moradi-Lakeh, Sok King OngRuwanthi Perera, Kameshwar Prasad, Jonathan E. Shaw, Janaka De Silva, Xueling Sim, Yuta Suzuki, Kathryn C.B. Tan, Xun Tang, Kavita Venkataraman, Rajitha Wickremasinghe, Hideo Yasunaga, Farhad Zamani, Steven H.J. Hageman*, Zijuan Huang, Hokyou Lee, Stephen Kaptoge, Jannick A.N. Dorresteijn, Lisa Pennells, Emanuele Di Angelantonio, Frank L.J. Visseren, Hyeon Chang Kim, Sofian Johar*, Emanuele Di Angelantonio, Michael Papadakis, Adam Timmis, Victor Aboyans, Panos Vardas, John William McEvoy, Maryam Kavousi, Jean Ferrieres,

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background and Aims: To improve upon the estimation of 10-year cardiovascular disease (CVD) event risk for individuals without prior CVD or diabetes mellitus in the Asia-Pacific region by systematic recalibration of the SCORE2 risk algorithm. Methods: The sex-specific and competing risk-adjusted SCORE2 algorithms were systematically recalibrated to reflect CVD incidence observed in four Asia-Pacific risk regions, defined according to country-level World Health Organization age- and sex-standardized CVD mortality rates. Using the same approach as applied for the original SCORE2 models, recalibration to each risk region was completed using expected CVD incidence and risk factor distributions from each region. Results: Risk region-specific CVD incidence was estimated using CVD mortality and incidence data on 8 405 574 individuals (556 421 CVD events). For external validation, data from 9 560 266 individuals without previous CVD or diabetes were analysed in 13 prospective studies from 12 countries (350 550 incident CVD events). The pooled C-index of the SCORE2 Asia-Pacific algorithms in the external validation datasets was. 710 [95% confidence interval (CI). 677-.744]. Cohort-specific C-indices ranged from. 605 (95% CI. 597-.613) to. 840 (95% CI. 771-.909). Estimated CVD risk varied several-fold across Asia-Pacific risk regions. For example, the estimated 10-year CVD risk for a 50-year-old non-smoker, with a systolic blood pressure of 140  mmHg, total cholesterol of 5.5  mmol/L, and high-density lipoprotein cholesterol of 1.3  mmol/L, ranged from 7% for men in low-risk countries to 14% for men in very-high-risk countries, and from 3% for women in low-risk countries to 13% for women in very-high-risk countries. Conclusions: The SCORE2 Asia-Pacific algorithms have been calibrated to estimate 10-year risk of CVD for apparently healthy people in Asia and Oceania, thereby enhancing the identification of individuals at higher risk of developing CVD across the Asia-Pacific region.

Original languageEnglish
Pages (from-to)702-715
Number of pages14
JournalEuropean heart journal
Volume46
Issue number8
DOIs
Publication statusPublished - 21 Feb 2025

Keywords

  • Cardiovascular disease
  • Primary prevention
  • Risk prediction
  • Ten-year CVD risk

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