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The SCORE Project

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Compared to the recommendations of the Second Joint Task Force of European Societies (2), which propose separate risk charts for type 2 diabetics, the SCORE project includes diabetic subjects, for whom no separate risk charts have been developed. Moreover, unlike Framingham and PROCAM algorithms that consider type 2 diabetes in score calculation, SCORE risk functions do not include a dichotomous diabetes variable even though diabetes is known to markedly increase CVD risk (2). The World Health Organization Multinational Study Group on Vascular Disease in Diabetes (23) has stated that the assessment of CVD risk in diabetes must include “diabetes-related” variables as well as conventional risk factors. Risk estimations should also be derived from large representative groups of diabetic subjects with homogeneous baseline data. Accordingly, UKPDS (6) has developed models for estimating absolute CHD risk in newly diagnosed type 2 diabetic men and women. When evaluating CVD risk in diabetic patients using the SCORE project, the CVD risk at every risk factor combination will be at least twice as high in diabetic men and up to four times higher in diabetic women when compared to the risk given in the SCORE charts.

The SCORE project therefore provides an “average” European chart for countries with no cohort data. It aims to promote the production of national cardiovascular risk charts using cardiovascular mortality data and SCORE risk functions with appropriate adjustments.

For more information, please visit the European Society of Cardiology website.

Reference

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2. Prevention of coronary heart disease in clinical practice. Recommendations of the Second Joint Task Force of European and other Societies on coronary prevention. Eur Heart J 1998; 19: 1434-503.

6. Stevens RJ, Kothari V, Adler AI, et al. The UKPDS risk engine: a model for the risk of coronary heart disease in Type II diabetes (UKPDS 56). Clin Sci (Lond) 2001; 101: 671-9.

23. Fuller JH, Stevens LK and Wang SL. Risk factors for cardiovascular mortality and morbidity: the WHO Mutinational Study of Vascular Disease in Diabetes. Diabetologia 2001; 44 Suppl 2: S54-64.

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