HeartScore

Last updated

HeartScore is a cardiovascular disease risk assessment and management tool developed by the European Society of Cardiology, aimed at supporting clinicians in optimising individual cardiovascular risk reduction.

Contents

Scientific Background

HeartScore is the interactive version of SCORE - Systematic COronary Risk Evaluation [1] - a cardiovascular disease risk assessment system initiated by the European Society of Cardiology, using data from 12 European cohort studies (N=205,178) covering a wide geographic spread of countries at different levels of cardiovascular risks. The SCORE data contains some 3-million person-years of observation and 7,934 fatal cardiovascular events.[ citation needed ]

The SCORE risk estimation is based on the following risk factors: gender, age, smoking, systolic blood pressure, total cholesterol, and estimates fatal cardiovascular disease events over a ten-year period.[ citation needed ]

HeartScore is one of the tools developed to implement the 2007 European guidelines on CVD prevention in clinical practice. [2]

Features

Available versions

In addition to two European versions for high/low risk countries, HeartScore now counts 13 national versions. HeartScore Sweden was the first national version to be launched in 2005, followed by versions in Germany, Greece, Poland, Spain, Cyprus, Slovakia, Czech Republic and Turkey. Translated versions now exist in Bosnia and Herzegovina, Russia, Romania and Croatia.[ citation needed ]

A roll-out plan of additional national versions has been defined for 2009–2010 within the framework of the EuroHeart Programme of the European Commission and according to countries specific requests. Further updates will be produced as knowledge evolves (new cohort studies, risk factors, end points)[ citation needed ]

Available formats

Three formats have been developed to cater for different users’ needs: [ citation needed ]

See also

Related Research Articles

Cardiology Branch of medicine dealing with the heart

Cardiology is a branch of medicine that deals with the disorders of the heart as well as some parts of the circulatory system. The field includes medical diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular heart disease and electrophysiology. Physicians who specialize in this field of medicine are called cardiologists, a specialty of internal medicine. Pediatric cardiologists are pediatricians who specialize in cardiology. Physicians who specialize in cardiac surgery are called cardiothoracic surgeons or cardiac surgeons, a specialty of general surgery.

Coronary artery disease Disease characterized by plaque building up in the arteries of the heart

Coronary artery disease (CAD), also called coronary heart disease (CHD), ischemic heart disease (IHD), or simply heart disease, involves the reduction of blood flow to the heart muscle due to build-up of plaque (atherosclerosis) in the arteries of the heart. It is the most common of the cardiovascular diseases. Types include stable angina, unstable angina, myocardial infarction, and sudden cardiac death. A common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck, or jaw. Occasionally it may feel like heartburn. Usually symptoms occur with exercise or emotional stress, last less than a few minutes, and improve with rest. Shortness of breath may also occur and sometimes no symptoms are present. In many cases, the first sign is a heart attack. Other complications include heart failure or an abnormal heartbeat.

Angina Chest discomfort due to not enough blood flow to heart muscle

Angina, also known as angina pectoris, is chest pain or pressure, usually due to insufficient blood flow to the heart muscle.

Cardiovascular disease Class of diseases that involve the heart or blood vessels

Cardiovascular disease (CVD) is a class of diseases that involve the heart or blood vessels. CVD includes coronary artery diseases (CAD) such as angina and myocardial infarction. Other CVDs include stroke, heart failure, hypertensive heart disease, rheumatic heart disease, cardiomyopathy, abnormal heart rhythms, congenital heart disease, valvular heart disease, carditis, aortic aneurysms, peripheral artery disease, thromboembolic disease, and venous thrombosis.

Cardiac stress test Measures the hearts ability to respond to external stress in a controlled clinical environment

A cardiac stress test is a cardiological test that measures the heart's ability to respond to external stress in a controlled clinical environment. The stress response is induced by exercise or by intravenous pharmacological stimulation.

American College of Cardiology

The American College of Cardiology (ACC), based in Washington, D.C., is a nonprofit medical association established in 1949. It bestows credentials upon cardiovascular specialists who meet its qualifications. Education is a core component of the college, which is also active in the formulation of health policy and the support of cardiovascular research.

The Framingham Heart Study is a long-term, ongoing cardiovascular cohort study of residents of the city of Framingham, Massachusetts. The study began in 1948 with 5,209 adult subjects from Framingham, and is now on its third generation of participants. Prior to the study almost nothing was known about the epidemiology of hypertensive or arteriosclerotic cardiovascular disease. Much of the now-common knowledge concerning heart disease, such as the effects of diet, exercise, and common medications such as aspirin, is based on this longitudinal study. It is a project of the National Heart, Lung, and Blood Institute, in collaboration with Boston University. Various health professionals from the hospitals and universities of Greater Boston staff the project.

Acute coronary syndrome

Acute coronary syndrome (ACS) is a syndrome due to decreased blood flow in the coronary arteries such that part of the heart muscle is unable to function properly or dies. The most common symptom is centrally located chest pain, often radiating to the left shoulder or angle of the jaw, crushing, central and associated with nausea and sweating. Many people with acute coronary syndromes present with symptoms other than chest pain, particularly women, older patients, and patients with diabetes mellitus.

In a clinical trial, the investigators must specify inclusion and exclusion criteria for participation in the study.

Hypertensive heart disease

Hypertensive heart disease includes a number of complications of high blood pressure that affect the heart. While there are several definitions of hypertensive heart disease in the medical literature, the term is most widely used in the context of the International Classification of Diseases (ICD) coding categories. The definition includes heart failure and other cardiac complications of hypertension when a causal relationship between the heart disease and hypertension is stated or implied on the death certificate. In 2013 hypertensive heart disease resulted in 1.07 million deaths as compared with 630,000 deaths in 1990.

A coronary CT calcium scan is a computed tomography (CT) scan of the heart for the assessment of severity of coronary artery disease. Specifically, it looks for calcium deposits in the coronary arteries that can narrow arteries and increase the risk of heart attack. This severity can be presented as Agatston score or coronary artery calcium (CAC) score. The CAC score is an independent marker of risk for cardiac events, cardiac mortality, and all-cause mortality. In addition, it provides additional prognostic information to other cardiovascular risk markers. A typical coronary CT calcium scan is done without the use of radiocontrast, but it can possibly be done from contrast-enhanced images as well, such as in coronary CT angiography.

The CHADS2 score and its updated version, the CHA2DS2-VASc score, are clinical prediction rules for estimating the risk of stroke in patients with non-rheumatic atrial fibrillation (AF), a common and serious heart arrhythmia associated with thromboembolic stroke. Such a score is used to determine whether or not treatment is required with anticoagulation therapy or antiplatelet therapy, since AF can cause stasis of blood in the upper heart chambers, leading to the formation of a mural thrombus that can dislodge into the blood flow, reach the brain, cut off supply to the brain, and cause a stroke.

Ticagrelor

Ticagrelor, sold under the brand name Brilinta among others, is a medication used for the prevention of stroke, heart attack and other events in people with acute coronary syndrome, meaning problems with blood supply in the coronary arteries. It acts as a platelet aggregation inhibitor by antagonising the P2Y12 receptor. The drug is produced by AstraZeneca.

Myocardial infarction Interruption of blood supply to a part of the heart

A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to a part of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck or jaw. Often it occurs in the center or left side of the chest and lasts for more than a few minutes. The discomfort may occasionally feel like heartburn. Other symptoms may include shortness of breath, nausea, feeling faint, a cold sweat or feeling tired. About 30% of people have atypical symptoms. Women more often present without chest pain and instead have neck pain, arm pain or feel tired. Among those over 75 years old, about 5% have had an MI with little or no history of symptoms. An MI may cause heart failure, an irregular heartbeat, cardiogenic shock or cardiac arrest.

Atrial fibrillation Rapid, irregular beating of the atria of the heart

Atrial fibrillation is an abnormal heart rhythm (arrhythmia) characterized by the rapid and irregular beating of the atrial chambers of the heart. It often begins as short periods of abnormal beating, which become longer or continuous over time. It may also start as other forms of arrhythmia such as atrial flutter that then transform into AF. Often episodes have no symptoms. Occasionally there may be heart palpitations, fainting, lightheadedness, shortness of breath, or chest pain. The disease is associated with an increased risk of heart failure, dementia, and stroke. It is a type of supraventricular tachycardia.

The Framingham Risk Score is a gender-specific algorithm used to estimate the 10-year cardiovascular risk of an individual. The Framingham Risk Score was first developed based on data obtained from the Framingham Heart Study, to estimate the 10-year risk of developing coronary heart disease. In order to assess the 10-year cardiovascular disease risk, cerebrovascular events, peripheral artery disease and heart failure were subsequently added as disease outcomes for the 2008 Framingham Risk Score, on top of coronary heart disease.

QRISK3 is a prediction algorithm for cardiovascular disease (CVD) that uses traditional risk factors together with body mass index, ethnicity, measures of deprivation, family history, chronic kidney disease, rheumatoid arthritis, atrial fibrillation, diabetes mellitus, and antihypertensive treatment.

The vertical auto profile (VAP) test is a cholesterol, lipid and lipoprotein test.

Erin D. Michos American cardiologist and researcher

Erin Kathleen Donnelly Michos is an American cardiologist. She is an associate professor of Medicine and Director of Women's Cardiovascular Health at Johns Hopkins School of Medicine. Michos is also an Associate Faculty of the Welch Center for Prevention, Epidemiology and Clinical Research at Johns Hopkins, and has a joint faculty appointment in the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health.

Cardiovascular disease in women is an integral area of research in the ongoing studies in women's health. Cardiovascular disease (CVD) is an umbrella term for a wide range of diseases affecting the heart and blood vessels, including, but not limited to coronary artery disease (CAD), stroke, cardiomyopathy, and aortic aneurysms.

References

  1. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project European Heart Journal 2003;24:987-1003
  2. European Guidelines on CVD Prevention in clinical practice, European Journal of Cardiovascular Prevention and Rehabilitation (EJCPR) 2007; vol 14 (suppl 2:S1-S113)