Development and Validation of Novel Residual Risk Scores for Patients With Atherosclerotic Cardiovascular Disease (ASCVD)
Authors' conclusion
RRS16 and RRS24 outperformed AHA guideline model in estimating the residual risk in patients with established ASCVD.
Study context
- Population
- Patients with established ASCVD; UK Biobank (baseline 2006–2010) and Mass General Brigham cohort (baseline 2007)
- Comparison
- RRS16 and RRS24 vs 2018 American Heart Association (AHA) guideline model
- Outcome
- Cardiovascular death
- Follow-up
- 10 years
Methodological detailsprospective observational cohort, external validation, UKB: 32,994 participants, 2,660 [8.0%] CV deaths, median follow-up 10 years (IQR 10-10), MGB: 54,969 patients, 6,927 [12.6%] CV deaths, median follow-up 9.4 years (5-10)
- Prospective observational cohort
- External validation
- UKB: 32,994 participants, 2,660 [8.0%] CV deaths, median follow-up 10 years (IQR 10-10)
- MGB: 54,969 patients, 6,927 [12.6%] CV deaths, median follow-up 9.4 years (5-10)
Performance
As reported in the abstract
C statistic, 10-year CV death
| Test or model | C statistic, UKB | C statistic, MGB |
|---|---|---|
| RRS16 | 0.752 (95% CI: 0.736-0.768) | 0.750 (0.744-0.756) |
| RRS24 | 0.784 (0.768-0.800) | — not stated in the abstract |
| AHA guideline model | 0.658 [0.642-0.674] | 0.580 [0.574-0.586] |
C statistic, UKB
RRS160.752 (95% CI: 0.736-0.768)
RRS240.784 (0.768-0.800)
AHA guideline model0.658 [0.642-0.674]
C statistic, MGB
RRS160.750 (0.744-0.756)
RRS24— not stated in the abstract
AHA guideline model0.580 [0.574-0.586]
— not stated in the abstract
Further findings
Calibration
- Both models well calibrated
- P > 0.1
Original publication
Development and Validation of Novel Residual Risk Scores for Patients With ASCVD. JACC Adv. Published 7 October 2025. doi:10.
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