Abstract / Description
Background and aimsHeart failure (HF) presents a significant and growing public health challenge. The aim of this study was to develop and validate SCORE2-HF, a model for HF risk estimation in European adults aged over 40 years without previous cardiovascular disease.MethodsUsing data from 25 prospective cohorts (14 countries, 611 778 individuals, 21 818 incident HF events), the sex-specific, competing risk-adjusted SCORE2-HF models were derived, including age, smoking status, systolic blood pressure, antihypertensive treatment, body mass index (BMI), estimated glomerular filtration rate, and type 2 diabetes mellitus (including age at diagnosis and glycated haemoglobin). Using Europe-wide statistics from the World Health Organization and linked health records from five countries (>36 million individuals, 515 466 incident HF events), models were recalibrated to contemporary 10-year and 30-year HF incidence in four European risk regions. SCORE2-HF was validated using data from three further cohorts (three countries; 1 336 824 participants; 36 841 incident HF events).ResultsIn the three external validation cohorts, C-indices (95% confidence interval) were .827 (.824-.829), .839 (.827-.850), and .874 (.863-.884). SCORE2-HF risks varied importantly by individual's risk factors and risk region. For example, in the low-risk region, the average 10-year risk for 70-year-old individuals with zero vs four adverse risk factors (smoking, type 2 diabetes mellitus, hypertension, and BMI ≥ 30 kg/m2), was 8% vs 24% in men and 6% vs 20% in women. By contrast, in the very high-risk region, the average SCORE2-HF risk with four adverse risk factors was 59% in 70-year-old men or women.ConclusionsSCORE2-HF-a model derived, recalibrated, and validated to estimate 10-year and 30-year risk of incident HF across European countries-may enhance the identification of individuals at higher risk of developing HF.