Přehled o publikaci
2026
Using SCORE2 with a risk chart or online calculator: impact on model performance, treatment eligibility, and cardiovascular disease prevention
HAGEMAN, Steven H. J.; Stephen KAPTOGE; Mari N. GYNNILD; Joris HOLTROP; Lisa PENNELLS et al.Basic information
Original name
Using SCORE2 with a risk chart or online calculator: impact on model performance, treatment eligibility, and cardiovascular disease prevention
Authors
HAGEMAN, Steven H. J.; Stephen KAPTOGE; Mari N. GYNNILD; Joris HOLTROP; Lisa PENNELLS; J. William MCEVOY; Martin BOBÁK; Andrzej PAJAK; Hynek PIKHART; Abdonas TAMOSIUNAS; Yvo M. SMULDERS; Francois MACH; David CARBALLO; Ewout W. STEYERBERG; Jannick A. N. DORRESTEIJN; Emanuele DI ANGELANTONIO; Angela M. WOOD and Frank L. J. VISSEREN
Edition
EUROPEAN HEART JOURNAL-QUALITY OF CARE AND CLINICAL OUTCOMES, OXFORD, OXFORD UNIV PRESS, 2026, 2058-5225
Other information
Language
English
Type of outcome
Article in a journal
Country of publisher
United Kingdom of Great Britain and Northern Ireland
Confidentiality degree
is not subject to a state or trade secret
References:
Marked to be transferred to RIV
No
Organization
Přírodovědecká fakulta – Repository – Repository
UT WoS
EID Scopus
Keywords in English
Risk prediction; Cardiovascular disease; Primary prevention; 10-year CVD risk
Changed: 24/3/2026 00:50, RNDr. Daniel Jakubík
Abstract
In the original language
Aims Current European Cardiovascular Disease (CVD) prevention guidelines recommend 10-year risk assessment using the SCORE2 model to identify individuals eligible for preventive treatment. Risk can be estimated using conventional risk charts or online calculators, though these methods may differ in precision and treatment classification.Methods and results Individuals without established CVD or diabetes mellitus were included from CPRD (UK, Europe's low risk region, n = 977 616) and HAPIEE (Czech Republic and Poland, high risk region and Lithuania, very high risk region, n = 11 739). During median 8.4 years [interquartile range (IQR) 5.0-10.4], 22 898 CVD events occurred. SCORE2 risk was estimated via two methods: an online calculator (unrounded SCORE2 algorithm) and risk charts from the 2021 ESC Prevention Guidelines. Predicted risks were higher with the risk charts than with the online calculator. In the low risk region, the median 10-year risk was 4.0% (IQR 2.0-6.0) with the risk charts vs. 3.7% (IQR 2.3-5.8) with the calculator. In the high/very high-risk region, risk was 9.0% (IQR 5.0-15.0) and 8.4% (IQR 4.5-13.9), respectively. Chart-based risk assessment resulted in higher treatment eligibility (6.3% vs. 4.0% in the low risk region; 51% vs. 43% in high/very high risk region). Discrimination was higher with the online calculator: difference in C-statistic +0.010 [95% confidence interval (CI) 0.008-0.012] in low risk region and +0.008 (95% CI 0.005-0.010) in high/very high risk region. Calibration was adequate for both approaches. Assuming a 50% relative risk reduction for preventive treatment, this corresponded to 53 vs. 46 events prevented per 1000 treated in the low-risk region and 80 vs. 74 in the high/very-high-risk region (calculator vs. risk charts).Conclusion Risk assessment using SCORE2 risk charts yields too high predicted risks and too broad treatment eligibility. By avoiding rounding of risk factors, the online calculator shows better discrimination.
