Including Measures of Chronic Kidney Disease to Improve Cardiovascular Risk Prediction by SCORE2 and SCORE2-OP
Eur J Prev Cardiol. 2023;30:8–16 DOI: 10.1093/eurjpc/zwac176
The 2021 ESC guideline on CVD prevention categorises moderate and severe CKD as high and very-high CVD risk status regardless of other factors like age and does not include eGFR and albuminuria in its SCORE2 and SCORE2-OP algorithms to predict CVD risk. Here, three CKD ‘Add-ons' to SCORE2 and SCORE2-OP were developed and validated: eGFR only, eGFR + urinary albumin-to-creatinine ratio (the primary Add-on), and eGFR + dipstick proteinuria.
In large validation datasets (n=5,997,719), the Add-ons improved C-statistics for SCORE2 and SCORE2-OP. Furthermore, in 57,485 European participants with CKD, SCORE2 or SCORE2-OP with a CKD Add-on showed a significant net reclassification improvement compared to the qualitative approach in the ESC guideline.
The authors believe that the CKD Add-ons will help clinicians and patients with CKD refine risk prediction and further personalise preventive therapies for CVD.