Conference Publication Details
Mandatory Fields
Mc Gorrian CM, Fitzgerald AP, Cooney MT, Dudina A, Whincup P, Vartiainen E, Jousilahti P, Conroy RM, Pyorala K, Graham IM.;
European Society of Cardiology
Validation of the SCOREplus model
Optional Fields

Purpose: The SCORE risk estimation system is widely used across Europe to estimate risk of fatal cardiovascular disease (CVD) events in primary prevention efforts. However, there remains a need to examine a broader endpoint, to make comparisons with other systems. This study describes the derivation and validation of a new SCORE risk estimation system using a broader endpoint of combined fatal and non fatal CVD events.

Methods: Data were accessed from the FINRISK cohort study (recruitment years 1982 and 1987). Persons with complete risk factor data were retained for analysis (n=13 507). The primary analysis method was a Cox proportional hazards regression, with age as the time variable; sex, smoking, systolic blood pressure and cholesterol as the independent variables; and first occurrence of any CVD event (fatal or non fatal) as the dependent variable. Validation studies examined discrimination, calibration and measures of global fit, in both FINRISK (internal validation) and in an independent cohort, the British Regional Heart Study (BRHS).

Results: SCORE-type charts with estimates of 10-year risk of fatal and non fatal CVD events by risk factor status were derived. Internal validation showed good discrimination: area under the receiver operator characteristic curve (ROC) was 0.78 for the cholesterol based model. Whilst the Hosmer Lemeshow test suggested a lack of fit, calibration plots showed appropriate callibration. External validation showed appropriate discrimination, and external calibration improved after a recalibration to external cohort event rates procedure.

Conclusions: A risk function for estimation of the risk of combined fatal and non fatal CVD events was derived and validated. Strengths and limitations compared with the original SCORE charts will be discussed.

European Heart Journal ( 2010 ) 31 ( Abstract Supplement ), 805
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