SCORE2-OP risk prediction algorithms: estimating incident cardiovascular event risk in older persons in four geographical risk regions

Tamar, I de Vries; Marie Therese Cooney; Randi M. Selmer; Steven H. J. Hageman; Lisa A. Pennells; Angela Wood; Stephen Kaptoge; Zhe Xu; Jan Westerink; Kjersti S. Rabanal; Grethe S. Tell; Haakon E. Meyer; Jannicke Igland; Inger Ariansen; Kunihiro Matsushita; Michael J. Blaha; Vijay Nambi; Ruth Peters; Nigel Beckett; Riitta Antikainen; Christopher J. Bulpitt; Majon Muller; Marielle H. Emmelot-Vonk; Stella Trompet; Wouter Jukema; Brian A. Ference; Martin Halle; Adam D. Timmis; Panos E. Vardas; Jannick A. N. Dorresteijn; Dirk De Bacquer; Emanuele Di Angelantonio; Frank L. J. Visseren; Ian M. Graham

doi:10.1093/eurheartj/ehab312

SCORE2-OP risk prediction algorithms: estimating incident cardiovascular event risk in older persons in four geographical risk regions

Tamar, I de Vries, Marie Therese Cooney, Randi M. Selmer, Steven H. J. Hageman, Lisa A. Pennells, Angela Wood, Stephen Kaptoge, Zhe Xu, Jan Westerink, Kjersti S. Rabanal, Grethe S. Tell, Haakon E. Meyer, Jannicke Igland, Inger Ariansen, Kunihiro Matsushita, Michael J. Blaha, Vijay Nambi, Ruth Peters, Nigel Beckett, Riitta AntikainenChristopher J. Bulpitt, Majon Muller, Marielle H. Emmelot-Vonk, Stella Trompet, Wouter Jukema, Brian A. Ference, Martin Halle, Adam D. Timmis, Panos E. Vardas, Jannick A. N. Dorresteijn, Dirk De Bacquer, Emanuele Di Angelantonio, Frank L. J. Visseren, Ian M. Graham

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

AIMS: The aim of this study was to derive and validate the SCORE2-Older Persons (SCORE2-OP) risk model to estimate 5- and 10-year risk of cardiovascular disease (CVD) in individuals aged over 70 years in four geographical risk regions.

METHODS AND RESULTS: Sex-specific competing risk-adjusted models for estimating CVD risk (CVD mortality, myocardial infarction, or stroke) were derived in individuals aged over 65 without pre-existing atherosclerotic CVD from the Cohort of Norway (28 503 individuals, 10 089 CVD events). Models included age, smoking status, diabetes, systolic blood pressure, and total- and high-density lipoprotein cholesterol. Four geographical risk regions were defined based on country-specific CVD mortality rates. Models were recalibrated to each region using region-specific estimated CVD incidence rates and risk factor distributions. For external validation, we analysed data from 6 additional study populations {338 615 individuals, 33 219 CVD validation cohorts, C-indices ranged between 0.63 [95% confidence interval (CI) 0.61-0.65] and 0.67 (0.64-0.69)}. Regional calibration of expected-vs.-observed risks was satisfactory. For given risk factor profiles, there was substantial variation across the four risk regions in the estimated 10-year CVD event risk.

CONCLUSIONS: The competing risk-adjusted SCORE2-OP model was derived, recalibrated, and externally validated to estimate 5- and 10-year CVD risk in older adults (aged 70 years or older) in four geographical risk regions. These models can be used for communicating the risk of CVD and potential benefit from risk factor treatment and may facilitate shared decision-making between clinicians and patients in CVD risk management in older persons.

Original language	English
Pages (from-to)	2455-2467
Number of pages	13
Journal	European heart journal
Volume	42
Issue number	25
DOIs	https://doi.org/10.1093/eurheartj/ehab312
Publication status	Published - 1 Jul 2021

Keywords

10-Year CVD risk
Cardiovascular disease
Older persons
Primary prevention
Risk assessment
Risk prediction

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de Vries, T. I., Cooney, M. T., Selmer, R. M., Hageman, S. H. J., Pennells, L. A., Wood, A., Kaptoge, S., Xu, Z., Westerink, J., Rabanal, K. S., Tell, G. S., Meyer, H. E., Igland, J., Ariansen, I., Matsushita, K., Blaha, M. J., Nambi, V., Peters, R., Beckett, N., ... Graham, I. M. (2021). SCORE2-OP risk prediction algorithms: estimating incident cardiovascular event risk in older persons in four geographical risk regions. European heart journal, 42(25), 2455-2467. https://doi.org/10.1093/eurheartj/ehab312

@article{7a517e28a82d4137a7fc6d98270ad7cc,

title = "SCORE2-OP risk prediction algorithms: estimating incident cardiovascular event risk in older persons in four geographical risk regions",

abstract = "AIMS: The aim of this study was to derive and validate the SCORE2-Older Persons (SCORE2-OP) risk model to estimate 5- and 10-year risk of cardiovascular disease (CVD) in individuals aged over 70 years in four geographical risk regions.METHODS AND RESULTS: Sex-specific competing risk-adjusted models for estimating CVD risk (CVD mortality, myocardial infarction, or stroke) were derived in individuals aged over 65 without pre-existing atherosclerotic CVD from the Cohort of Norway (28 503 individuals, 10 089 CVD events). Models included age, smoking status, diabetes, systolic blood pressure, and total- and high-density lipoprotein cholesterol. Four geographical risk regions were defined based on country-specific CVD mortality rates. Models were recalibrated to each region using region-specific estimated CVD incidence rates and risk factor distributions. For external validation, we analysed data from 6 additional study populations {338 615 individuals, 33 219 CVD validation cohorts, C-indices ranged between 0.63 [95% confidence interval (CI) 0.61-0.65] and 0.67 (0.64-0.69)}. Regional calibration of expected-vs.-observed risks was satisfactory. For given risk factor profiles, there was substantial variation across the four risk regions in the estimated 10-year CVD event risk.CONCLUSIONS: The competing risk-adjusted SCORE2-OP model was derived, recalibrated, and externally validated to estimate 5- and 10-year CVD risk in older adults (aged 70 years or older) in four geographical risk regions. These models can be used for communicating the risk of CVD and potential benefit from risk factor treatment and may facilitate shared decision-making between clinicians and patients in CVD risk management in older persons.",

keywords = "10-Year CVD risk, Cardiovascular disease, Older persons, Primary prevention, Risk assessment, Risk prediction",

author = "{de Vries}, {Tamar, I} and Cooney, {Marie Therese} and Selmer, {Randi M.} and Hageman, {Steven H. J.} and Pennells, {Lisa A.} and Angela Wood and Stephen Kaptoge and Zhe Xu and Jan Westerink and Rabanal, {Kjersti S.} and Tell, {Grethe S.} and Meyer, {Haakon E.} and Jannicke Igland and Inger Ariansen and Kunihiro Matsushita and Blaha, {Michael J.} and Vijay Nambi and Ruth Peters and Nigel Beckett and Riitta Antikainen and Bulpitt, {Christopher J.} and Majon Muller and Emmelot-Vonk, {Marielle H.} and Stella Trompet and Wouter Jukema and Ference, {Brian A.} and Martin Halle and Timmis, {Adam D.} and Vardas, {Panos E.} and Dorresteijn, {Jannick A. N.} and {De Bacquer}, Dirk and {Di Angelantonio}, Emanuele and Visseren, {Frank L. J.} and Graham, {Ian M.}",

note = "Publisher Copyright: {\textcopyright} 2021 European Society of Cardiology, 2021.",

year = "2021",

month = jul,

day = "1",

doi = "10.1093/eurheartj/ehab312",

language = "English",

volume = "42",

pages = "2455--2467",

number = "25",

}

de Vries, TI, Cooney, MT, Selmer, RM, Hageman, SHJ, Pennells, LA, Wood, A, Kaptoge, S, Xu, Z, Westerink, J, Rabanal, KS, Tell, GS, Meyer, HE, Igland, J, Ariansen, I, Matsushita, K, Blaha, MJ, Nambi, V, Peters, R, Beckett, N, Antikainen, R, Bulpitt, CJ, Muller, M, Emmelot-Vonk, MH, Trompet, S, Jukema, W, Ference, BA, Halle, M, Timmis, AD, Vardas, PE, Dorresteijn, JAN, De Bacquer, D, Di Angelantonio, E, Visseren, FLJ & Graham, IM 2021, 'SCORE2-OP risk prediction algorithms: estimating incident cardiovascular event risk in older persons in four geographical risk regions', European heart journal, vol. 42, no. 25, pp. 2455-2467. https://doi.org/10.1093/eurheartj/ehab312

TY - JOUR

T1 - SCORE2-OP risk prediction algorithms: estimating incident cardiovascular event risk in older persons in four geographical risk regions

AU - de Vries, Tamar, I

AU - Cooney, Marie Therese

AU - Selmer, Randi M.

AU - Hageman, Steven H. J.

AU - Pennells, Lisa A.

AU - Wood, Angela

AU - Kaptoge, Stephen

AU - Xu, Zhe

AU - Westerink, Jan

AU - Rabanal, Kjersti S.

AU - Tell, Grethe S.

AU - Meyer, Haakon E.

AU - Igland, Jannicke

AU - Ariansen, Inger

AU - Matsushita, Kunihiro

AU - Blaha, Michael J.

AU - Nambi, Vijay

AU - Peters, Ruth

AU - Beckett, Nigel

AU - Antikainen, Riitta

AU - Bulpitt, Christopher J.

AU - Muller, Majon

AU - Emmelot-Vonk, Marielle H.

AU - Trompet, Stella

AU - Jukema, Wouter

AU - Ference, Brian A.

AU - Halle, Martin

AU - Timmis, Adam D.

AU - Vardas, Panos E.

AU - Dorresteijn, Jannick A. N.

AU - De Bacquer, Dirk

AU - Di Angelantonio, Emanuele

AU - Visseren, Frank L. J.

AU - Graham, Ian M.

PY - 2021/7/1

Y1 - 2021/7/1

N2 - AIMS: The aim of this study was to derive and validate the SCORE2-Older Persons (SCORE2-OP) risk model to estimate 5- and 10-year risk of cardiovascular disease (CVD) in individuals aged over 70 years in four geographical risk regions.METHODS AND RESULTS: Sex-specific competing risk-adjusted models for estimating CVD risk (CVD mortality, myocardial infarction, or stroke) were derived in individuals aged over 65 without pre-existing atherosclerotic CVD from the Cohort of Norway (28 503 individuals, 10 089 CVD events). Models included age, smoking status, diabetes, systolic blood pressure, and total- and high-density lipoprotein cholesterol. Four geographical risk regions were defined based on country-specific CVD mortality rates. Models were recalibrated to each region using region-specific estimated CVD incidence rates and risk factor distributions. For external validation, we analysed data from 6 additional study populations {338 615 individuals, 33 219 CVD validation cohorts, C-indices ranged between 0.63 [95% confidence interval (CI) 0.61-0.65] and 0.67 (0.64-0.69)}. Regional calibration of expected-vs.-observed risks was satisfactory. For given risk factor profiles, there was substantial variation across the four risk regions in the estimated 10-year CVD event risk.CONCLUSIONS: The competing risk-adjusted SCORE2-OP model was derived, recalibrated, and externally validated to estimate 5- and 10-year CVD risk in older adults (aged 70 years or older) in four geographical risk regions. These models can be used for communicating the risk of CVD and potential benefit from risk factor treatment and may facilitate shared decision-making between clinicians and patients in CVD risk management in older persons.

AB - AIMS: The aim of this study was to derive and validate the SCORE2-Older Persons (SCORE2-OP) risk model to estimate 5- and 10-year risk of cardiovascular disease (CVD) in individuals aged over 70 years in four geographical risk regions.METHODS AND RESULTS: Sex-specific competing risk-adjusted models for estimating CVD risk (CVD mortality, myocardial infarction, or stroke) were derived in individuals aged over 65 without pre-existing atherosclerotic CVD from the Cohort of Norway (28 503 individuals, 10 089 CVD events). Models included age, smoking status, diabetes, systolic blood pressure, and total- and high-density lipoprotein cholesterol. Four geographical risk regions were defined based on country-specific CVD mortality rates. Models were recalibrated to each region using region-specific estimated CVD incidence rates and risk factor distributions. For external validation, we analysed data from 6 additional study populations {338 615 individuals, 33 219 CVD validation cohorts, C-indices ranged between 0.63 [95% confidence interval (CI) 0.61-0.65] and 0.67 (0.64-0.69)}. Regional calibration of expected-vs.-observed risks was satisfactory. For given risk factor profiles, there was substantial variation across the four risk regions in the estimated 10-year CVD event risk.CONCLUSIONS: The competing risk-adjusted SCORE2-OP model was derived, recalibrated, and externally validated to estimate 5- and 10-year CVD risk in older adults (aged 70 years or older) in four geographical risk regions. These models can be used for communicating the risk of CVD and potential benefit from risk factor treatment and may facilitate shared decision-making between clinicians and patients in CVD risk management in older persons.

KW - 10-Year CVD risk

KW - Cardiovascular disease

KW - Older persons

KW - Primary prevention

KW - Risk assessment

KW - Risk prediction

UR - http://www.scopus.com/inward/record.url?scp=85110941439&partnerID=8YFLogxK

U2 - 10.1093/eurheartj/ehab312

DO - 10.1093/eurheartj/ehab312

M3 - Article

C2 - 34120185

SN - 0195-668X

VL - 42

SP - 2455

EP - 2467

JO - European heart journal

JF - European heart journal

IS - 25

ER -

SCORE2-OP risk prediction algorithms: estimating incident cardiovascular event risk in older persons in four geographical risk regions

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Keywords

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