Multinational validation of the PREVENT and SCORE2 cardiovascular risk equations across 6.4 million individuals

作者：Brendon L. Neuen, Rupert W. Major, Morgan E. Grams, Yingying Sang, Josef Coresh, Shoshana H. Ballew, Aditya Surapaneni, Natalia Alencar de Pinho, Johan Arnlov, Clare Arnott, Samira Bell, Jarett Berry, Hermann Brenner, Elizabeth Ciemins, Alexander R. Chang, Mary Cushman, James A. de Lemos, Juan Miguel Díaz‐Tocados, Alfredo E. Farjat, Robert A. Fletcher, Ron T. Gansevoort, Hiddo J. L. Heerspink, William G. Herrington, Chuan Hong, Edward Horwitz, Shih-Jen Hwang, Simerjot K. Jassal, Philip A. Kalra, Ronit Katz, Sadiya S. Khan, Csaba P. Kövesdy, Florian Kronenberg, Jennifer S. Lees, Donald M. Lloyd-Jones, José Geraldo Mill, Д А Наймарк, Chiadi Ndumele, Kevan R. Polkinghorne, Bruce M. Psaty, Patrick Schloemer, Michael Shlipak, Prabin Shrestha, Zean Song, N Staplin, Dominik Steubl, Priya Vart, Frank L.J. Visseren, Mark Woodward, Kazumasa Yamagishi, Bessie A. Young, Charumathi Sabanayagam, José M. Valdivielso, ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation), John Chalmers, Katie Harris, Aichi (Aichi Workers’ Cohort Study), Hiroshi Yatsuya, Yuanying Li, Midori Takada, ALTITUDE, AusDiab (Australian Diabetes, Obesity, and Lifestyle Study), Steven Chadban, CANVAS (including CANVAS-R) (Canagliflozin Cardiovascular Assessment Study Program), Bruce Neal, CARMELINA, CAROLINA, CIRCS (Circulatory Risk in Communities Study), Isao Muraki, Hironori Imano, Hiroyasu Iso, Natalia Alencar de Pinho, Ziad Massy, Benedicte Stengel, Marie Metzger, Kenneth W. Mahaffey, Meg Jardine, Vlado Perkovic, CRIC (Chronic Renal Insufficiency Cohort Study), Matthew Weir, Jing Chen, James Lash, Panduranga Rao, DAPA-CKD, DHS (Dallas Heart Study), Colby Ayers, Amit Khera, Parag Joshi, Amil Shah, Michael J. Pencina, Matthew Engelhard, Mu Niu, Haoyuan Wang, ELSA-Brasil (Brazilian Longitudinal Study of Adult Health), Paula Bracco, Maria de Jesus Mendes da Fonseca, Isabela Bensenor, Maria da Conceição Chagas de Almeida, Luana Giatti, EMPA-KIDNEY (The Study of Heart and Kidney Protection with Empagliflozin), Richard Haynes, Parminder Judge, FIDELITY (Finerenone in Chronic Kidney Disease and Type 2 Diabetes: Combined FIDELIO-DKD and FIGARO-DKD Trial Programme Analysis), GCKD (German Chronic Kidney Disease Study), Ulla T. Schultheiss, Wibke Bechtel-Walz, Markus Schneider, Turgay Saritas, Ewan Pearson, Colin Palmer, Shona J. Livingstone, Emilie Lambourg, Nefrona (Observatorio Nacional de Aterosclerosis en Nefrologia), Serafi Cambray, Marcelino Bermudez-Lopez, Maria Luisa Martin-Conde, Maite Caus, OLDW (Optum Labs Data Warehouse), ONTARGET, PSP-CKD (Primary-Secondary Care Partnership to Prevent Adverse Outcomes in Chronic Kidney Disease), Nigel J. Brunskill, James F. Medcalf, Rancho Bernardo Study, Jaclyn Bergstrom, Joachim Ix, Dena Rifkin, RCAV (Racial and Cardiovascular Risk Anomalies in CKD Cohort), Keiichi Sumida, REGARDS (Reasons for Geographic And Racial Differences in Stroke Study), Orlando Gutierrez, Katharine Cheung, Titi Ilori, RENAAL (Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan), SEED (Singapore Epidemiology of Eye Diseases), Ching Yu Cheng, Cancan Xue, Xiayin Zhang, Crystal Chong, SHARP (Study of Heart and Renal Protection), Colin Baigent, Martin Landray, SKS (Salford Kidney Study), Rajkumar Chinnadurai, Smeeta Sinha, Sharmilee Rengarajan, Ivona Baricevic-Jones, SMART (Second Manifestations of ARTerial Disease Study), Robin W. M. Vernooij, SONAR, SPRINT (Systolic Blood Pressure Intervention Trial), Simon Benjamin Ascher, Sunnybrook Cohort, Navdeep Tangri, TRANSCEND, ULSAM (Uppsala Longitudinal Study of Adult Men), Anders Larsson, Vilmantas Giedraitis · 发表于：Nature Medicine · 年份：2026 · DOI：10.1038/s41591-026-04437-z · 被引用次数：9 · 研究领域：Lipoproteins and Cardiovascular Health、Blood Pressure and Hypertension Studies、Diabetes, Cardiovascular Risks, and Lipoproteins

The American Heart Association's PREVENT equations estimate risk of total cardiovascular disease (CVD), atherosclerotic cardiovascular disease (ASCVD) and heart failure (HF) to guide lipid-lowering and blood pressure-lowering therapy in people ages 30-79 years in the United States. The SCORE2 risk algorithm is used to estimate CVD risk for similar purposes in people ages 40 and older in Europe. Neither set of equations has been comprehensively validated in global observational cohorts and randomized trials. In this study, in 44 observational cohorts and 18 randomized trials, we assessed discrimination and calibration of the two risk algorithms across geographical regions (North America, Europe and Asia/Other or multiregional trials). We also created scaling factors for risk prediction over 1-9 years using the PREVENT equations, enabling shorter-term risk prediction for research purposes or to facilitate clinical trial enrollment. Over 5.1 years of mean follow-up, 293,737 PREVENT total CVD events (fatal and non-fatal ASCVD or HF) and 258,086 SCORE2 CVD events (myocardial infarction, stroke or cardiovascular death) were observed among 6,422,714 and 5,437,384 individuals, respectively. Despite differences in CVD outcome definitions, target populations and predictor variables, overall discrimination and calibration were similar for both equations, with generally good performance across regions, including in multiregional randomized trials. These findings lend support for adoption...