Systematic Coronary Risk Evaluation (SCORE)
Key result
SCORE and SCORE2 systems provide updated calibrated risk estimates for cardiovascular events across Europe.
Why the study?
Clinical estimation of the combined effect of several risk factors is unreliable, necessitating risk estimation systems to guide clinical practice.
Key Points
- Review the development and performance of the European Society of Cardiology's Systematic Coronary Risk Evaluation (SCORE) model and outline future trajectories for cardiovascular risk prediction.
- Examined the principles and calibration data underlying the original European Society of Cardiology SCORE risk estimation system.
- Assessed updates leading to the SCORE2 tool across low, moderate, high, and very high-risk regions of Europe.
- SCORE was established to overcome the clinical unreliability of informally combining multiple cardiovascular risk factors.
- SCORE2 delivers recalibrated, regionalized risk estimates for total cardiovascular events across Europe.
- Future risk assessment strategies propose tracking cumulative years of exposure to risk profiles and integrating early-life genetic data for lifetime risk modeling.
PICO
P
Population
Cardiovascular risk
I
Intervention / Comparator
Systematic Coronary Risk Evaluation (SCORE)
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Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“This risk tool is much more powerful and superior than what doctors have used for decades. It will fit seamlessly into current prevention programmes with substantial real-world impact by improving the prevention of cardiovascular diseases across Europe before they strike.”
“This new risk tool is a major advance and will save many more people from developing heart attacks, stroke and heart disease. It will be the new gold standard for doctors to determine which patients are at the highest risk of these conditions, and enable tailored treatment and lifestyle advice to be given much earlier.”
Implication
The paper reviews the evolution of the ESC SCORE risk estimation system and outlines future directions, including SCORE 2 and lifetime risk estimation.
Abstract
Clinical estimation of the combined effect of several risk factors is unreliable and this resulted in the development of a number of risk estimation systems to guide clinical practice. Here, after defining general principles of risk estimation, the authors describe the evolution of the European Society of Cardiology's (ESC) Systematic COronary Risk Evaluation (SCORE) risk estimation system and some learnings from the data. They move on to describe the establishment of the ESC's Cardiovascular Risk Collaboration and outline its proposed research directions. First among these is the evolution of SCORE 2, which provides updated, calibrated risk estimates for total cardiovascular events for low, moderate, high, and very high-risk regions of Europe. The authors conclude by considering that the future of risk estimation may be to express risk as years of exposure to a cardiovascular risk factor profile rather than risk over a fixed time period, such as 10 years, and how advances in genetics may permit individualized lifetime risk estimation from childhood on.
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Cite This Study
Graham et al. (2021) conducted a review in Cardiovascular risk. Systematic Coronary Risk Evaluation (SCORE) was evaluated. The Systematic Coronary Risk Evaluation (SCORE) and SCORE2 systems provide updated, calibrated risk estimates for total cardiovascular events across different regions of Europe.