Factors influencing Systemic Coronary Risk Estimation 2 (SCORE2)

Abstract

Background: This study aimed to identify factors associated with the 10-year risk of fatal and nonfatal cardiovascular disease (CVD) events in apparently healthy individuals aged 40–69 years. Methods: 148 patients without established CVD were divided into low-risk (70 patients) and high-risk (78 patients) groups based on their CVD risk in SCORE2. Results: High-risk patients presented with higher left atrial volume index (LAVI) (p = 0.003), left ventricular mass index (LVMI) (p < 0.001), and ratio of peak velocity of early diastolic transmitral flow to peak velocity of early diastolic mitral annular motion (E/E’) (p < 0.001) but lower oxygen uptake at anaerobic threshold (VO2AT) (p = 0.02) and maximal oxygen uptake (VO2max) (p = 0.008), compared to their counterparts. High-risk patients also had higher values of high-sensitivity cardiac troponin T (hs-cTnT) (p < 0.001) and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) (p < 0.001), and lower level of glomerular filtration rate (GFR) (p < 0.001). In a multiple logistic regression model, E/E’ > 6.75 cm/s (OR 3.9, 95% CI: 1.5-10.3; p = 0.004) and hs-cTnT > 4.8 pg/mL (OR 6.02, 95% CI: 2.3-15.8; p < 0.001) were independently associated with high and very high CVD risk. SCORE2 (%) correlated positively with metabolic age (R Spearman = 0.79; p < 0.001), hs-cTnT (R = 0.6; p < 0.001), and NT-proBNP (R = 0.5; p < 0.001) and negatively with GFR (R = –0.5; p < 0.001) and VO2max (mL/min/kg) (R = –0.3; p < 0.001). Conclusions: Elevated E/E’ and higher hs-cTnT level independently predict high and very high risk in SCORE2. The increasing 10-year cardiovascular disease risk correlates with higher metabolic age, higher levels of NT-proBNP and hs-cTnT, and lower level of GFR. (Cardiol J 2025; 32, 2: 153–163).