New approaches in cardiovascular risk estimation and stratification

Authors

  • Aurel GROSU Institute of Cardiology
  • Angela MARINA Institute of Cardiology
  • Victor RUDI Institute of Cardiology

DOI:

https://doi.org/10.52692/1857-0011.2024.1-78.15

Keywords:

Cardiovascular disease, Risk prediction, Risk assessment, Primary prevention, 10-Year CVD risk, Older persons, Diabetus Mellitus

Abstract

Cardiovascular diseases remain a significant and growing problem in the Republic of Moldova, representing more than half of all deaths and leading to significant morbidity. It is now recognized that the burden of cardiovascular disease (CVD) can be ameliorated by vigorous risk reduction and primary prevention, which remain an important priority for all health policy developers. Being one of the European countries with a high risk for cardiovascular diseases, Moldova faces major difficulties in implementing CVD prevention measures both at the population and individual level. This article summarizes the main novelties of the guidelines for the prevention of cardiovascular diseases of the European Society of Cardiology (ESC), recently published, examining their positive aspects, but also their applicability to routine clinical practice, taking into account the socioeconomic characteristics of Moldova. Cardiovascular risk estimation is an essential step to reduce the onset of adverse cardiovascular events. For this purpose, the Systematic Coronary Risk Evaluation (SCORE) risk chart method was used in Europe. The effort to prevent atherosclerotic CVD is focused on identifying patients who would benefit mostly from the treatment of CVD risk factors.

Author Biographies

Aurel GROSU, Institute of Cardiology

Doctor Habilitated in Medical Sciences, University Professor

Angela MARINA , Institute of Cardiology

medic cardiolog

Victor RUDI, Institute of Cardiology

doctor of Medical Sciences

References

ESC Guidelines on cardiovascular disease prevention in clinical practice: Developed by the Task Force for cardiovascular disease prevention in clinical practice with representatives of the European Society of Cardiology and 12 medical societies With the special contribution of the European Association of Preventive Cardiology (EAPC), Eur Heart J, Vol 42, 2021, p. 3227–3337

ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;140:e596–e646

Anuarul statistic al sistemului de sănătate din Moldova, Chișinău aa 2021 - 2022

Ebrahim S, Taylor F, Ward K, et al. Multiple risk factor interventions for primary prevention of coronary heart disease. Cochrane Database Syst Rev 2011:CD001561

Si S, Moss JR, Sullivan TR, Newton SS, Stocks NP. Effectiveness of general practice-based health checks: a systematic review and meta-analysis. Br J Gen Pract 2014;64:e47-53.

Koon K. Teo, MBBCh, PhD, FRCPC, FCCS, and Talha Rafiq, MSc Cardiovascular Risk Factors and Prevention: A Perspective From Developing Countries. Canadian Journal of Cardiology 37 (2021) 733-743

Guy De Backer, New insights in cardiovascular risk estimation and stratification. e-Journal of Cardiology Practice Vol. 22, N° 16 - 22 Jun 2022

V.Arrarte,et al./Comments on the 2021ESC Guidelines on cardiovascular disease prevention in clinical practice. Rev Esp Cardiol.2022;75(5):364–369367

ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk: The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society. Eur Heart J, Vol 41, Issue 1, 2020, p. 111–188

Mancia G, Kreutz R, Brunström M, et al. 2023 ESH guidelines for the management of arterial hypertension the Task Force for the management of arterial hypertension of the European Society of Hypertension: endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA). J Hypertens 2023;41:1874-2071.

ESC Guidelines for the management of cardiovascular disease in patients with diabetes: Developed by the task force on the management of cardiovascular disease in patients with diabetes of the European Society of Cardiology. Eur Heart J, Vol 44, Issue 39, 2023, p. 4043–4140

STEPS: prevalence of noncommunicable disease risk factors in the Republic of Moldova, 2021, WHO, https://www.who.int/europe/publications/i/item/WHO-EURO-2022-6785-46551-67555

Protocol Clinic Național ,, Prevenția Bolilor Cardiovasculare”, PCN-423,Ministerul Sănătăți, Republica Moldova, https://ms.gov.md/legislatie/ghiduri-protocoale-standarde/cardiologie-2/

Ian M Graham, Emanuele Di Angelantonio, Radu Huculeci, New Way to „SCORE” Risk: Updates on the ESC Scoring System and Incorporation into ESC Cardiovascular Prevention Guidelines, Curr Cardiol Rep 2022 Nov;24(11):1679-1684.

SCORE2-OP risk prediction algorithms:estimating incident cardiovascular event risk in older persons in four geographical risk regions, SCORE2-OP working group and ESC Cardiovascular risk collaboration, European Heart Journal (2021) 42, p. 2455–2467

Carlos Brotonsa, Irene Morala, Diana Fernándeza, et al. Assessment of the New SCORE OP Cardiovascular Risk Charts in Patients Older Than 65 Years. Rev Esp Cardiol., Vol. 69. Issue 10, pages 981-983

SCORE2-OP Working Group and ESC Cardiovascular Risk Collaboration. SCORE2-OP risk prediction algorithms: estimating incident cardiovascular event risk in older persons in four geographical risk regions. Eur Heart J 2021;42:2455-67

Lin JS, Evans CV, Johnson E, Redmond N, et al. Nontraditional Risk Factors in Cardiovascular Disease Risk Assessment: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA 2018;320:281–297

Orsolya Csenteri1, Zoltán Jancsó1, Gergő József Szöllösi1, Differences of cardiovascular risk assessment in clinical practice using SCORE and SCORE2, BMJ (2022) Volume 9, Issue 2

SCORE2-Diabetes: 10-year cardiovascular risk estimation in type 2 diabetes in Europe, SCORE2- Diabetes Working Group and the ESC Cardiovascular Risk Collaboration, European Heart Journal (2023) 44, 2544–2556

Comprehensive Management of Cardiovascular Risk Factors for Adults With Type 2 Diabetes, Circulation. 2022;145:e722–e759. DOI: 10.1161/CIR.0000000000001040

Liew SM, Lee WK, Khoo FM, et.al. Can doctors and patients correctly estimate cardiovascular risk? A cross-sectional study in primary care. BMJ Open. 2018;8:e01771.

Conroy RM, Pyörälä K, Fitzgerald AP, et al; SCORE project group. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J. 2003;24:987-1003

De Backer GG. New risk markers for cardiovascular prevention. Curr Atheroscler Rep. 2014;16:1-8.

Cooney MT, Selmer R, Lindman A, Tverdal A, Menotti A, Thomsen T, De Backer G, De Bacquer D, Tell GS, Njolstad I, Graham IM; SCORE and CONOR investigators. Cardiovascular risk estimation in older persons: SCORE-O.P. Eur J Prev Cardiol. 2016; 23: 1093-103.

Published

2024-08-05

Issue

Section

Research Article

Categories