Key result
The SCORE2 scale classified 98% of relatively healthy individuals as high or very high risk, but their incidence of cardiovascular events was only 1% over 5 years.
Why the study?
The effectiveness of cardiovascular risk stratification using the SCORE2 scale needed evaluation in a Tomsk adult population sample based on 5-year follow-up.
Does the SCORE2 scale accurately predict cardiovascular events in an urban adult population aged 40-64 years?
Cohort (n=971)
Does the SCORE2 scale accurately predict cardiovascular events in an urban adult population aged 40-64 years?
The SCORE2 scale significantly overestimated cardiovascular risk in a relatively healthy Russian cohort, classifying 98% as high or very high risk despite a 5-year event rate of only 1%.
Answers are grounded in this paper and cite their sources.
Clinical-anamnestic plus carotid ultrasound stratification captures most events; leaves open SCORE2 utility without local recalibration in Russian adults.
Aim . To study the effectiveness of cardiovascular risk (CVR) stratification using the systematic coronary risk evaluation 2 (SCORE2) in a Tomsk adult population sample based on 5-year follow-up. Material and methods . The results of a survey of a population sample of 971 people aged 40 to 64 years in Tomsk were analyzed as part of the ESSE-RF study. Based on clinical and anamnestic data on atherosclerotic cardiovascular diseases (with and without taking into account carotid ultrasound data), as well as diabetes or chronic kidney disease (CKD), individuals with high and very high risk were identified. CVR in relatively healthy individuals was assessed using the SCORE2 scale. The incidence of cardiovascular events (CVEs) (cardiovascular death, non-fatal myocardial infarction (MI) or stroke (n=34)) were determined in different risk groups based on 5-year follow-up. Results . Coronary artery disease was registered in 140 examined persons (15%), type 2 diabetes in 137 people (14%), CKD in 217 (22%), history of MI or stroke in 5,3%. The category of high and very high CVR according to clinical and anamnestic data included 400 examined persons (41%), which accounted for 22 out of 34 (65%) CVEs over the 5-year follow-up period. The use of the plaque presence criterion identified in 386 subjects (40%) expanded this group to 605 subjects (62%), who accounted for 30 out of 34 (88%) CVEs during the follow-up period (5%), which significantly increased the detection of subjects with CVEs (p=0,04). According to the SCORE2 scale, 98% of 366 relatively healthy subjects were at high and very high risk, but CVE incidence during the follow-up period was only 1% (p=0,004). Conclusion . The results of the 5-year follow-up demonstrated the effectiveness of the modern CVR stratification algorithm in a population sample of Tomsk aged 40 to 64 years in identifying subjects with high and very high risk based on clinical and anamnestic data, taking into account carotid ultrasound data, who account for the majority (88%) of CVEs (cardiovascular death, non-fatal MI, stroke). The SCORE2 scale identified high and very high risk in 98% of relatively healthy individuals, while the incidence of CVEs in them was only 1% over 5-year follow-up, which does not confirm the effectiveness and feasibility of SCORE2 scale in CVR stratification.
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Заирова et al. (2024) conducted a cohort in Cardiovascular risk (n=971). SCORE2 cardiovascular risk stratification was evaluated on Cardiovascular events (cardiovascular death, non-fatal myocardial infarction, or stroke) (p=0.004). The SCORE2 scale classified 98% of relatively healthy individuals as high or very high risk, but their incidence of cardiovascular events was only 1% over 5 years.
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