Abstract P450: The Moli-Sani Risk Score, a New Algorithm for Measuring the Global Impact of Nine Modifiable Cardiovascular Risk Factors

Introduction: Cardiovascular (CV) disease, the leading cause of death globally, is largely preventable through targeting modifiable risk factors. Scores of modifiable CV risk factors able to collect the combined effect of all the included components were mainly developed in US populations, or do not include nutritional aspects. Hypothesis: We assessed the hypothesis that an algorithm for measuring the global impact of nine modifiable CV risk factors, including dietary factors is useful in a Mediterranean population. Methods: Data on 16 656 participants of the Moli-sani Study (age ≥45y, 47% men), Italy, were used. The Moli-sani Risk Score (MRS) was calculated as a weighted sum of smoking, adherence to Mediterranean diet, LDL and HDL cholesterol, triglycerides, blood pressure, glucose, physical activity and relative fat mass. A composite outcome of fatal or non-fatal CV events was used. The Risk-and-Prevention Study, Italy (N=8606) acted as external validation cohort and the Life's Simple 7 metric as benchmark. Results: In the derivation cohort, 816 CV events occurred in 8.1 years (median) of follow-up. In multivariable Cox analysis adjusted for non-modifiable risk factors, 1-unit increase in the MRS was associated with a hazard ratio (HR) for CV events of 1.07 (95%CI: 1.06-1.08). In comparison with individuals in the first quartile, those in the fourth quartile of the MRS had HR=3.18 (2.54-3.97, Table). In the validation cohort, individuals in the fourth quartile reported a HR=1.69 (1.39-2.05). In comparison with the Life's Simple 7 metric, the MRS performed better in the derivation cohort and similarly in the validation cohort. Conclusions: The Moli-sani Risk Score is a validated, replicable algorithm predictive of CV events, based on nine modifiable CV risk factors, well performing in a Mediterranean population. The MRS can be useful to evaluate the efficacy of preventive strategies, to design intervention schemes and to communicate effectiveness of a preventive action, increasing compliance to the strategy itself.