Estimating the Risk of Cardiovascular Events in U.S. Veterans Using the SMART Risk Score
Authors' conclusion
The VA SMART risk score can estimate the long-term risk of recurrent cardiovascular events in U.S. Veterans and could help implement individualized risk mitigation strategies.
Study context
- Population
- US Veterans referred for initial outpatient cardiology evaluation, Veterans Affairs (VA), 2003–2010 (mean age 60 ± 8.9 years, 96% male)test cohort n = 378,611
- Participants
- 472,702 veterans
- Exposure
- Low risk vs Moderate risk vs High risk vs Very high risk
- Outcome
- Composite MACE:
- All-cause death
- Ischemic stroke
- Nonfatal MI
- Follow-up
- 10 years
Methodological detailsrisk score development and validation, Cox regression and survival curves used to develop and validate the VA SMART score
- Risk score development and validation
- Cox regression and survival curves used to develop and validate the VA SMART score
Main finding
As reported in the abstract
Observed MACE rates by VA-SMART risk group (test cohort)
- All intergroup comparisons
- P < 0.0001
- Discrimination (C-statistic), similar to other established risk models
- 0.67
Observational data: associations, not effects.
Further findings
Major adverse cardiovascular events (MACE) components
- Most MACE events were all-cause death; nonfatal MI and stroke also high, especially in very high-risk group
Original publication
Estimating the Risk of Cardiovascular Events in U.S. Veterans Using the SMART Risk Score. JACC Adv. Published 12 December 2024. doi:10.
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