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The Systematic COronary Risk Evaluation (SCORE) in a large UK population: 10-year follow-up in the EPIC-Norfolk

Harald T Jørstad1, Ersen B Colkesen2, Madelon Minneboo3

  • 1Department of Cardiology, Academic Medical Centre, Amsterdam, The Netherlands h.t.jorstad@amc.uva.nl.

European Journal of Preventive Cardiology
|September 5, 2013
PubMed

Insights

The Systematic COronary Risk Evaluation (SCORE) low-risk algorithm accurately predicts cardiovascular disease (CVD) mortality in the UK. This study validates the UK

Area of Science:

  • Cardiology
  • Public Health
  • Epidemiology

Background:

  • The European Society of Cardiology recommends the Systematic COronary Risk Evaluation (SCORE) algorithm for cardiovascular disease (CVD) risk stratification.
  • The UK was reclassified as a low-risk country in the 2012 European Guidelines on CVD Prevention.
  • The performance of the SCORE algorithm in the UK population required validation.

Purpose of the Study:

  • To validate the performance of the SCORE high-risk and low-risk algorithms in predicting CVD mortality in the UK.
  • To assess the accuracy of the SCORE algorithm's reclassification of the UK as a low-risk country.

Main Methods:

  • Utilized the European Prospective Investigation of Cancer-Norfolk (EPIC-Norfolk) prospective population study cohort.
  • Included 15,171 individuals aged 39-65 without prior CVD or diabetes.
  • Calculated predicted CVD mortality using SCORE algorithms and compared with observed 10-year CVD mortality.

Main Results:

  • The SCORE low-risk algorithm predicted 1.55% 10-year CVD mortality (95% CI 1.52-1.58).
  • The SCORE high-risk algorithm predicted 2.85% 10-year CVD mortality (95% CI 2.80-2.90).
  • Observed 10-year CVD mortality was 1.25% (95% CI 1.08-1.44), with similar results across subgroups.

Conclusions:

  • The SCORE low-risk algorithm demonstrated better performance in predicting 10-year CVD mortality in the UK.
  • Findings support the reclassification of the UK as a low-risk country for CVD.
  • The SCORE algorithm's risk stratification is validated for the UK population.
Abstract

Keywords:
Cardiovascular diseasesalgorithmsrisk factors

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