Factors influencing Systemic Coronary Risk Estimation 2 (SCORE2)

Area of Science:

• Cardiology
• Preventive Medicine
• Biomarker Research

Background:

• Cardiovascular disease (CVD) poses a significant health risk.
• Identifying early risk factors in asymptomatic individuals is crucial for prevention.
• The 10-year risk assessment is vital for managing CVD events.

Purpose of the Study:

• To identify key factors associated with the 10-year risk of cardiovascular disease (CVD) events.
• To investigate predictors of high CVD risk in apparently healthy adults aged 40-69.
• To correlate CVD risk scores with specific clinical and biochemical markers.

Main Methods:

• 148 individuals without established CVD were stratified into low-risk and high-risk groups using SCORE2.
• Echocardiographic parameters (LAVI, LVMI, E/E'), cardiorespiratory fitness (VO₂AT, VO2max), and biomarkers (hs-cTnT, NT-proBNP, GFR) were assessed.
• Multiple logistic regression and correlation analyses were performed to identify independent predictors and associations.

Main Results:

• High-risk individuals exhibited elevated left atrial volume index (LAVI), left ventricular mass index (LVMI), and E/E', alongside reduced oxygen uptake (VO₂AT, VO2max).
• Higher levels of high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal prohormone of brain natriuretic peptide (NT-proBNP), and lower glomerular filtration rate (GFR) were observed in high-risk patients.
• E/E' > 6.75 cm/s and hs-cTnT > 4.8 pg/ml were independent predictors of high CVD risk. SCORE2 correlated with metabolic age, hs-cTnT, NT-proBNP, GFR, and VO2max.

Conclusions:

• Elevated E/E' and hs-cTnT levels are independent predictors of high and very high cardiovascular disease risk.
• Increased 10-year CVD risk is associated with higher metabolic age, elevated NT-proBNP and hs-cTnT, and decreased GFR.
• These findings highlight potential biomarkers for early CVD risk stratification in asymptomatic individuals.