Aortic & peripheral vascular disease
Carotid ultrasound and systematic coronary risk assessment 2 in the prediction of cardiovascular events
Authors' conclusion
Carotid ultrasound adds predictive performance to SCORE2 for assessment of CVD risk. Using SCORE2 without considering carotid atherosclerosis could under- or over-estimate the risk.
Study context
- Population
- Non-diabetic participants aged 46–68 years with carotid ultrasound
- Participants
- 4,588 participants
- Exposure
- SCORE2 plus carotid plaque or intima media thickness (IMT) vs SCORE2 alone
- Outcome
- Incremental value of adding carotid plaque or IMT to SCORE2 for predicting CVD events (C-statistics, continuous NRI, IDI)
- Follow-up
- First 10 years
Main finding
As reported in the abstract
CVD events, adding plaque to SCORE2
Improvement in C-statistics
2.20%
P < 0.0001
SCORE2 + plaque
Integrated discrimination improvement (IDI)
0.70%
P < 0.0001
SCORE2 + plaque
Continuous net reclassification improvement (NRI)
46.1%
P < 0.0001
SCORE2 + plaque
Observational data: associations, not effects.
Further findings
Calibration of SCORE2: observed vs predicted 10-year CVD risk, by carotid plaque
Observed
Predicted
- Calibration of SCORE2: observed vs predicted 10-year CVD risk, by carotid plaque — SCORE2 over-predicted risk without carotid plaque
- P < 0.0001
- Calibration of SCORE2: observed vs predicted 10-year CVD risk, by carotid plaque — SCORE2 under-predicted risk with carotid plaque
- P = 0.043
Original publication
Carotid ultrasound and systematic coronary risk assessment 2 in the prediction of cardiovascular events. Eur J Prev Cardiol. Published 9 May 2023. doi:10.
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