The SMART risk score accurately predicted 10-year MACE risk with event rates of 2.9% to 79.2% across risk groups and outperformed established models (c=0.772).
Does the SMART risk score accurately predict the up to 10-year risk of MACE in non-veteran U.S. cardiology outpatients?
The SMART risk score accurately predicts up to 10-year risk of major adverse cardiovascular events in U.S. cardiology outpatients, outperforming established risk models.
Absolute Event Rate: 0% vs 0%
Abstract Background Secondary Manifestations of Arterial Disease (SMART) risk score based projection of risk for cardiovascular (CV) events can help devise risk mitigation strategies. Objective Use of the SMART risk score to compute the risk for major adverse cardiovascular events (MACE) in the non-veteran U.S. patients. Methods We used our healthcare system's electronic health record informatics and data warehouse to identify patients at their first outpatient cardiology evaluation between April 2014 and October 2023 to estimate up to 10-year risk of MACE, a composite of all-cause death, ischemic stroke, and non-fatal myocardial infarction (MI). Cox regression, accelerated failure time model, and survival analysis were used to develop and validate the SMART risk score. Results The study population of 162,514 patients (mean age 62.7 ± 14.7 years, 46.7% female) were divided into development (60%) and test (40%) cohorts; median follow-up 3.9 years (interquartile range 3.0–4.9). The SMART risk score allowed accurate estimation of MACE. Patients in low (6.6%), moderate (6.6%-22%), high (22%-47%), and very high (≥47%) SMART risk score groups had observed MACE events rates of 2.9%, 14.0%, 31.7% and 79.2%, respectively in the test cohort (p0.0001 for all inter-group comparisons). Most MACE events were all-cause death, with nonfatal MI and stroke also being high, especially in the very high-risk group. The SMART score outperformed established risk prediction models (c statistic= 0.772). Conclusion The SMART risk score can provide accurate estimation of up to 10-year risk of CV events in U.S patients and could be potentially leveraged to develop individualized risk mitigation strategies.Kaplan Meier Curves for Test cohort
Vazquez et al. (Sat,) reported a other. The SMART risk score accurately predicted 10-year MACE risk with event rates of 2.9% to 79.2% across risk groups and outperformed established models (c=0.772).