ArticleFrontiers in cardiovascular medicine2025
Comparative evaluation of ASCVD, SCORE-2, and HEARTS risk scores in Colombian adults at risk of type 2 diabetes: stratification, concordance, and associated factors.
Article in Frontiers in cardiovascular medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The Atherosclerotic Cardiovascular Disease Risk Estimator (ASCVD), Systematic Coronary Risk Evaluation (SCORE-2), and HEARTS risk scales are commonly used to estimate cardiovascular risk (CVR); however, their applicability may vary depending on the population context. Objective: This study aims to evaluate stratification, concordance, and associated clinical and social factors across three CVR scales in Colombian adults at risk of type 2 diabetes. Methods: A cross-sectional study was conducted among 868 adults. CVR was categorized as low, moderate, or high based on ASCVD, SCORE-2, and HEARTS criteria. Descriptive statistics were used for categorical variables, and comparisons were made using chi-square tests. Continuous variables were analyzed using the Kruskal-Wallis test. Concordance between scales was assessed using weighted Cohen's kappa (wκ), and ordinal logistic regression was applied to identify factors associated with CVR. Results: SCORE-2 classified 34.9% of participants as high cardiovascular risk, compared with 3.6% by ASCVD and 4.7% by HEARTS. Moderate agreement was observed between ASCVD and HEARTS (wκ = 0.49; Conclusion: SCORE-2 classified a higher proportion of individuals as high cardiovascular risk, while ASCVD and HEARTS were more conservative. The low level of agreement between the scales highlights the need for local validation of CVR assessment tools.
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