Key result
In older adults without established ASCVD, 83.8% were categorized as having a very high 10-year risk using SCORE2-OP, with increasing age significantly elevating the likelihood of very high risk (OR 1.85).
Why the study?
Anticipated 10-year ASCVD risk surpasses conventional thresholds in nearly all individuals aged 70 and older, necessitating evaluation of ASCVD risk and risk modifiers in apparently healthy elderly persons.
Cross-Sectional (n=253)
No
In a cohort of elderly patients without established ASCVD, all were found to be at least at high cardiovascular risk based on SCORE2-OP, indicating that age predominantly drives estimated ASCVD risk in this demographic.
Answers are grounded in this paper and cite their sources.
SCORE2-OP classifies most older adults without ASCVD as very high risk; leaves open whether age-driven estimates warrant refined thresholds or outcome validation before guiding care.
Introduction: Age is a major risk factor that affects the likelihood of developing atherosclerotic cardiovascular disease (ASCVD). The anticipated 10-year ASCVD risk for nearly all individuals aged 70 years and older surpasses conventional risk thresholds. When considering treatment for risk factors, it is important to take into account ASCVD risk modifiers, such as malnutrition, polypharmacy, and comorbidities. Objectives: The aim of this study was to estimate ASCVD risk in apparently healthy (without established ASCVD) elderly persons. We also evaluated several biochemical and clinical indicators to better characterize the studied population. Patients and methods: A total of 253 elderly individuals aged 70 years and older, who were apparently healthy and did not have established atherosclerotic cardiovascular disease (ASCVD), were enrolled in the study. The Systemic Coronary Risk Estimation 2-Older Persons (SCORE2-OP) model was utilized to assess their 10-year risk of developing ASCVD. Results: Among the 253 participants, 41 (16.2%) were classified as high risk, while 212 (83.8%) were categorized as very high risk. No individuals had a low ASCVD risk (defined as less than 7.5%). The median 10-year risk of developing ASCVD for the study group was 23% (ranging from 17% to 32%). The number of individuals identified as very high risk increased significantly with age, with nearly all participants aged 75 years and older being considered very high risk. An age of 75 years or older is associated with a very high risk for ASCVD, supported by a C-statistic of 0.92, which reflects a positive predictive value (PPV) of 99% and a negative predictive value (NPV) of 52% (p < 0.001). Conclusions: Elderly individuals without established ASCVD constitute a varied group. The majority were identified as being at very high risk for ASCVD. Age and hypertension were the primary factors contributing to this risk. Furthermore, modifiers of ASCVD risk, including malnutrition, polypharmacy, and multimorbidity, were commonly observed.
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Żurański et al. (2024) conducted a cross-sectional in Without established atherosclerotic cardiovascular disease (n=253). Increasing age was evaluated on Very high 10-year cardiovascular risk (OR 1.85). In older adults without established ASCVD, 83.8% were categorized as having a very high 10-year risk using SCORE2-OP, with increasing age significantly elevating the likelihood of very high risk (OR 1.85).
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