Correlation and Agreement Between the Score2 and Prevent 10-Year Atherosclerotic Cardiovascular Disease Risk Scores: Insights From Coronary Computed Tomography Angiography

Abstract

Background: We aimed to evaluate the correlation and agreement between the Systemic Coronary Risk Estimation 2 (SCORE2) and Predicting Risk of CVD EVENTs (PREVENT) 10-year ASCVD risk scores by incorporating computed tomographic (CT) data to assess differences between the scoring systems. Methods: The PREVENT risk score was calculated for 171 patients, while the SCORE2 and SCORE2 Older Persons (OP) risk scores were calculated for 113 patients. Coronary artery calcium (CAC) scores were calculated, and the grading of coronary artery disease (CAD) was assessed according to these scores. Results: According to the PREVENT risk category, 79 patients (46.2%) were in the low-risk category, 32 (18.7%) were in the borderline-risk category, and 51 (29.8%) were in the intermediate-risk category. In contrast, the SCORE2 systems placed 32 patients (28.3%) in the low- to moderate-risk categories. Only 9 patients (5.3%) were classified as being at high risk by PREVENT, while SCORE2 categorized 39 patients (34.5%) as being at high risk and 42 patients (37.2%) as being at very high risk. There was a strong correlation between the scores (r = 85, p < 0.001), with a Bland-Altman plot analysis showing a bias of -3.71 points and the limits of agreement ranging from -16.06 to 8.64. The total CAC score and CAD grading were significantly different across the PREVENT risk groups (p < 0.001 for all) but were similar across the SCORE2 groups (p = 0.3 and p = 0.051, respectively). Conclusions: There is a strong correlation and agreement between the two risk scores. However, SCORE2 tends to categorize more patients as high-risk than PREVENT does. Additionally, the PREVENT risk categories are more effective than SCORE2 in determining the likelihood of CAD based on CT results.