Prevention & lipidsCohort study
Predictive improvement of adding coronary calcium score and a genetic risk score to a traditional risk model for cardiovascular event prediction
- Prospective cohort study
- population-based
Authors' conclusion
In our population, CACS added to SCORE2 had better ability than GRS in CV event risk prediction, discrimination, and reclassification.
Study context
- Population
- Asymptomatic subjects free of clinical coronary disease and diabetes (GENEMACOR-study controls)
- Participants
- 1,002 subjects
- Exposure
- SCORE2 plus coronary artery calcium score (CACS) and/or genetic risk score (GRS) vs SCORE2 alone
- Outcome
- Discriminative ability for cardiovascular (CV) events (Harrell's C-statistic)
Main finding
As reported in the abstract
C-statistic for CV events
SCORE2
0.608
C-statistic
SCORE2 + CACS
0.749
C-statistic
SCORE2 + CACS + GRS
0.802
C-statistic
- SCORE2 + CACS
- C-statistic 0.749; P = 0.001
- SCORE2 + CACS + GRS
- C-statistic 0.802; P = 0.0008
Observational data: associations, not effects.
Further findings
| Outcome | HR | P value |
|---|---|---|
| CV events, highest vs lowest category (multivariable Cox) — SCORE2 highest category vs SCORE2 lowest category | 2.9 | P = 0.003 |
| CV events, highest vs lowest category (multivariable Cox) — CACS highest category vs CACS lowest category | 5.0 | P < 0.0001 |
| CV events, highest vs lowest category (multivariable Cox) — GRS highest category vs GRS lowest category | 3.2 | P = 0.003 |
Reclassification (continuous net reclassification improvement (NRI))
- Continuous NRI reclassified >70% of the population
Original publication
Predictive improvement of adding coronary calcium score and a genetic risk score to a traditional risk model for cardiovascular event prediction. Eur J Prev Cardiol. Published 4 January 2024. doi:10.1093/eurjpc/zwae005
Summarised from the published abstract; every number is checked against it