Comparison of SCORE and SCORE 2 model for cardiovascular risk stratification in men and women from high risk European country

Abstract Funding Acknowledgements Type of funding sources: None. European Society of Cardiology has recently introduced new SCORE 2 algorhythm for cardiovascular risk assessment in apparently healthy individuals. However, there are limited data from high risk countries on CV risk stratification and potential gender differences in risk estimation using SCORE 2 model. The aim of the current study was to compare risk prediction using SCORE 2 and previous SCORE model and to assess the potential gender differences in risk estimation. Methods Our study included 1361 apparently healthy individuals (mean age 56±9 years, 61% women) without known CV disease or risk factors aged 40 to 70 years old. Data on CV risk factors were prospectively collected in 20 primary care centers throughout Serbia from January 2020 to December 2020. CV risk was assessed both by SCORE and SCORE 2 model. Based on CV risk profile individuals were stratified in three categories: low to intermediate, high and very high risk category. Results In overall population using SCORE model 57.6% of individuals were in low-intermediate group, 20.9% were classified as high risk group and 21.5% as very high risk group. By the use of SCORE 2 model 1046/1361 (77%) individuals were shifted to higher risk category (Figure). In comparison to men women had lower both systolic (139 ± 19 mmHg vs 144 ± 18 mmHg in men p < 0.001) and diastolic (84 ± 9 mmHg vs 88 ± 10mmHg in men, p < 0.001 )blood pressure, lower BMI (26.4 ± 0.5 kg/m2 vs 27.4 ± 5.0 kg/m2 in men, p= 0.036) and higher values of HDL cholesterol (1.5 ± 0.5 mmol/L vs. 1.3 ± 0.4 mmol/L in men, p < 0.001). Smoking was more prevalent in men (49%) than in women (42%), p=0.04. There were no gender differences in age (56 ± 9 years for both genders) and non-HDL cholesterol ( 4.86 ± 1.24 mmol in men vs. 4.75 ± 1.23 mmol/l in women, p= 0.100). More women (85.9%) than men (62.6%) were shifted in higher risk category using SCORE 2 in comparison to SCORE (p < 0.001) (Figure). Conclusion By the use of SCORE 2 instead of SCORE prediction model for CV risk stratification in contemporary high risk European population significant proportion of apparently healthy individuals are shifted to higher risk category. In spite of having better CV risk factors profile, more women than men were shifted in higher risk category.