Differences of cardiovascular risk assessment in clinical practice using SCORE and SCORE2

OBJECTIVE: Cardiovascular risk estimation is an essential step to reduce the onset of adverse cardiovascular events. For this purpose, the Systematic Coronary Risk Evaluation (SCORE) risk chart method was used in Europe. In 2021, the SCORE2 algorithm was released, bringing changes in the calculation methodology. This study assessed and compared the level of cardiovascular risk in a population aged 40-65 years using the SCORE and SCORE2 methodologies. METHODS: This cross-sectional study included a total of 85 802 patients in Hungary. Cardiovascular risk levels were determined using the SCORE and SCORE2 risk estimation methods. RESULTS: Using SCORE, 97.7% of men aged 40-50 years were classified as low-moderate risk, which decreased to 32.4% using SCORE2. Using SCORE, 100% of women aged 40-50 years were classified as low-moderate risk, compared with 75.6% using SCORE2. Using SCORE, 36.8% of men aged 50-65 years were classified as high risk and 14.8% as very high risk, and 5.4% of women aged 50-65 years were classified as high risk and 0.5% as very high risk. In this age group, using SCORE2, 50% of men were classified as high risk and 25.8% as very high risk, and 38.8% of women were classified as high risk and 11.9% as very high risk. CONCLUSIONS: When the SCORE2 method was used instead of SCORE 43.91% of the whole population were classified with a higher level of risk, which represents a radical increase in the number of patients with high or very high cardiovascular risk.