SCORE2-diabetes vs SCORE for evaluation of cardiovascular risk in diabetic patients.

Abstract

Cardiovascular diseases are the leading cause of mortality worldwide, with the risk being exacerbated in patients with type 2 diabetes mellitus (T2DM). Traditionally, the Systematic coronary risk evaluation (SCORE) system has been used to estimate the 10-year risk of fatal cardiovascular events. However, in 2023, the European Society of Cardiology introduced SCORE2-Diabetes, a diabetes-specific model that incorporates disease-related variables. This study aimed to compare the cardiovascular risk estimates from the SCORE and SCORE2-diabetes algorithms in patients with type 2 diabetes in primary care, assessing adherence to Low-density Lipoprotein (LDL) therapeutic targets and the impact on cardiovascular risk management. This cross-sectional study evaluated 360 diabetic patients aged 40-65 years in a primary care unit in northern Portugal, comparing the cardiovascular risk estimated by the SCORE and SCORE2-diabetes models. The results showed that the SCORE model classified 95% of patients as high risk and 5% as very high risk, while the SCORE2-diabetes model categorized patients into four groups: 6% low risk, 30% moderate, 57% high, and 7% very high risk. Additionally, 58% of patients did not meet LDL therapeutic targets by SCORE2-Diabetes. The findings suggest that SCORE2-diabetes provides better discrimination of cardiovascular risk, allowing for more personalized treatment. Its integration into clinical systems could optimize decision-making, reduce therapeutic inertia, and improve clinical outcomes in patients with T2DM.