Pol Arch Intern Med. 2026 Feb 3:17219. doi: 10.20452/pamw.17219. Online ahead of print.
ABSTRACT
INTRODUCTION: Accurate cardiovascular disease (CVD) risk prediction is crucial for personalized preventive medicine.
OBJECTIVES: To evaluate the effect of traditional risk factors on CVD mortality, and to validate the prognostic performance of the SCORE2 model for prediction of 18-year risk of CVD death.
PATIENTS AND METHODS: The cohort study included 6780 residents of Krakow (54% women), free of CVD and diabetes at baseline, recruited between 2002 and 2005. The mean baseline age of men and women was 57.2 (6.9) years and 56.6 (6.8) years respectively.
RESULTS: In 50 246 and 62 906 person-years of follow-up in men and women, respectively, cumulative CVD mortality was 9.0% in men and 5.2% in women, with competing (non-CVD) mortality of 19.2% and 12.0%. Smoking and hypertension were strongly associated with CVD mortality, whereas associations with total cholesterol (TC) and HDL cholesterol (HDL-C) were weaker. A newly derived model including age, smoking, systolic blood pressure (SBP), TC and HDL-C achieved Harrell's C-Index of 0.693 in men and 0.757 in women. The model including SCORE2 as a continuous variable showed similar discrimination (C-index 0.718 in men and 0.754 in women), while SCORE2 categories demonstrated poorer predictive performance (C-index 0.589 and 0.676, respectively).
CONCLUSIONS: Smoking and elevated blood pressure were confirmed as major long-term predictors of CVD mortality. The prognostic performance of SCORE2 as a continuous measure was good and comparable to the derived prediction model including age and traditional risk factors. However, the predictive accuracy of SCORE2 categories was lower, particularly in men.
PMID:41631483 | DOI:10.20452/pamw.17219