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SCORE2 risk prediction algorithms: new models to estimate 10-year risk of cardiovascular disease in Europe

2021; Oxford University Press; Volume: 42; Issue: 25 Linguagem: Inglês

10.1093/eurheartj/ehab309

1522-9645

Steven H J Hageman, Lisa Pennells, Francisco Ojeda, Stephen Kaptoge, Kari Kuulasmaa, Tamar I. de Vries, Zhe Xu, Frank Kee, Ryan Chung, Angela Wood, John W. McEvoy, Giovanni Veronesi, Thomas Bolton, Stephan Achenbach, Krasimira Aleksandrova, Pilar Amiano, Donostia-San Sebastián, Philippe Amouyel, Jonas Andersson, Stephan J. L. Bakker, Rui Bebiano Da Providencia Costa, Joline W. J. Beulens, Michael J. Blaha, Martin Bobák, Jolanda M.A. Boer, Catalina Bonet, Fabrice Bonnet, Marie‐Christine Boutron‐Ruault, Tonje Braaten, Hermann Brenner, Fabian J. Brunner, Eric J. Brunner, Mattias Brunström, Julie E. Buring, Adam S. Butterworth, Naděžda Čapková, Giancarlo Cesana, Christina Chrysohoou, Sandra Colorado‐Yohar, Nancy R. Cook, Cyrus Cooper, Christina C. Dahm, Karina W. Davidson, Elaine Dennison, Augusto Di Castelnuovo, Chiara Donfrancesco, Marcus Dörr, Agnieszka Doryńska, Mats Eliasson, Gunnar Engström, Pietro Ferrari, Maurizio Ferrario, Ian Ford, Michael Fu, Ron T. Gansevoort, Simona Giampaoli, Richard F. Gillum, Agustı́n Gómez de la Cámara, Guıdo Grassı, Per‐Olof Hansson, Radu Huculeci, Kristian Hveem, Licia Iacoviello, M. Kamran Ikram, Torben Jørgensen, Bijoy Joseph, Pekka Jousilahti, J. Wouter Jukema, Rudolf Kaaks, Verena Katzke, Maryam Kavousi, Stefan Kiechl, Jens Klotsche, Wolfgang König, Richard A. Kronmal, Růžena Kubínová, Anna Kucharska‐Newton, Kristi Läll, Nils Lehmann, David M. Leistner, Allan Linneberg, David Lora, Thiess Lorenz, Wentian Lu, Dalia Lukšienė, Magnus Nakrem Lyngbakken, Christina Magnussen, Sofia Malyutina, Alejandro Marín Ibañez, Giovanna Masala, Ellisiv B. Mathiesen, Kuni Matsushita, Tom Meade, Olle Melander, Helmut E. Meyer, Karel G.M. Moons, Conchi Moreno‐Iribas, David C. Muller, Thomas Münzel, Y.P. Nikitin, Børge G. Nordestgaard, Torbjørn Omland, Charlotte Onland, Kim Overvad, Chris J. Packard, Andrzej Pająk, Luigi Palmieri, Demosthenes B. Panagiotakos, Salvatore Panico, Aurora Perez‐Cornago, Annette Peters, Arto Pietilä, Hynek Pikhart, Bruce M. Psaty, Fosca Quarti‐Trevano, J.R. García, Elio Ríboli, Paul M. Ridker, Beatriz L. Rodríguez, Miguel Rodríguez‐Barranco, Annika Rosengren, Ronan Roussel, Carlotta Sacerdote, Susana Sans, Naveed Sattar, Catarina Schiborn, Börge Schmidt, Ben Schöttker, Matthias B. Schulze, Joseph E. Schwartz, Randi Selmer, Steven Shea, Martin J. Shipley, Sabina Sieri, Stefan Söderberg, Reecha Sofat, Abdonas Tamosiunas, Barbara Thorand, Taavi Tillmann, Anne Tjønneland, Tammy Y. N. Tong, Antonia Trichopoulou, ­Rosario ­Tumino, Hugh Tunstall‐Pedoe, Anne Tybjærg‐Hansen, Ioanna Tzoulaki, Amber van der Heijden, Yvonne T. van der Schouw, W. M. Monique Verschuren, Henry Völzke, Christoph Waldeyer, Nicholas J. Wareham, Elisabete Weiderpass, Franz Weidinger, Philipp S. Wild, Johann Willeit, Peter Willeit, Tom Wilsgaard, Mark Woodward, Tanja Zeller, Dudan Zhang, Bin Zhou, Paul Dendale, Brian A. Ference, Martin Halle, Adam Timmis, Panos Vardas, John Danesh, Ian Graham, Veikko Salomaa, Frank L.J. Visseren, Dirk De Bacquer, Stefan Blankenberg, Jannick A N Dorresteijn, Emanuele Di Angelantonio,

Lipoproteins and Cardiovascular Health

Abstract 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.