Background

The aim of this study was to develop an updated model to predict10-year cardiovascular disease (CVD) risk for Greek adults, i.e., the HellenicSCORE II+, based on smoking, systolic blood pressure (SBP), total and High-Density-Lipoprotein-(HDL) cholesterol levels, and stratified by age group, sex, history of diabetes, and Lipoprotein (Lp)-a levels.

Methods

Individual CVD risk scores were calculated through logit-function models, using the beta-coefficients derived from SCORE2. The Attica Study data were used for the calibration (3,042 participants, aged 45(14) years; 49.1% men). Discrimination ability of the HellenicSCORE II+ was assessed using C-index (range 0-1), adjusted for competing risks.

Results

The mean HellenicSCORE II+ score was 6.3% (95% Confidence Interval (CI) 5.9% to 6.6%) for men and 3.7% (95% CI 3.5% to 4.0%) for women (p<0.001), and were higher compared to the relevant SCORE2; 23.5% of men were classified as low risk, 40.2% as moderate and 36.3% as high risk, whereas the corresponding percentages for women were 56.2%, 18.6% and 25.2%. C-statistic index was 0.88 for women and 0.79 for men, when the HellenicSCORE II+ was applied to the ATTICA Study data, suggesting very good accuracy. Stratified analysis by Lp(a) levels led to a 4% improvement in correct classification among participants with high Lp(a).

Conclusion

HellenicSCORE II+ values were higher than SCORE2, confirming that the Greek population is at moderate-to-high CVD risk. Stratification by Lp(a) levels may assist to better identify individuals at high CVD risk.

中文翻译：

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通过糖尿病状况和脂蛋白-a 水平预测 10 年心血管疾病风险；HellenicSCORE II+

背景

本研究的目的是开发一个更新的模型来预测希腊成年人 10 年心血管疾病 (CVD) 风险，即 HellenicSCORE II+，基于吸烟、收缩压 (SBP)、总脂蛋白和高密度脂蛋白- (HDL) 胆固醇水平，并按年龄组、性别、糖尿病史和脂蛋白 (Lp)-a 水平进行分层。

方法

个人 CVD 风险评分是通过 logit 函数模型使用 SCORE2 派生的 beta 系数计算得出的。Attica 研究数据用于校准（3,042 名参与者，年龄 45(14) 岁；49.1% 为男性）。使用 C 指数（范围 0-1）评估 HellenicSCORE II+ 的辨别能力，并根据竞争风险进行调整。

结果

男性的平均 HellenicSCORE II+ 评分为 6.3%（95% 置信区间 (CI) 5.9% 至 6.6%），女性为 3.7%（95% CI 3.5% 至 4.0%）（p<0.001），并且高于男性相关的 SCORE2；23.5%的男性被列为低风险，40.2%为中风险，36.3%为高风险，而女性的相应比例分别为56.2%、18.6%和25.2%。当将 HellenicSCORE II+ 应用于 ATTICA 研究数据时，女性 C 统计指数为 0.88，男性为 0.79，表明准确性非常高。按 Lp(a) 水平进行分层分析，使 Lp(a) 高的参与者的正确分类率提高了 4%。

结论

HellenicSCORE II+ 值高于 SCORE2，证实希腊人口处于中度至高度 CVD 风险。按 Lp(a) 水平进行分层可能有助于更好地识别具有高 CVD 风险的个体。