SCORE2-OP
10-year cardiovascular risk from age 70. Accounts for the competing risk of non-cardiovascular death.
Updated · Methodology
For people aged 70 and over without established cardiovascular disease. Below 70 use SCORE2, and in type 2 diabetes at ages 40 to 69 use SCORE2-Diabetes.
About this calculator
In people over 70 the usual risk scales break down for a clear reason: the competing risk of dying from something else becomes comparable to cardiovascular risk itself, and a model that ignores it overestimates. SCORE2-OP is built on a Fine and Gray model where that competition is part of the calculation, so the scale does not carry logic derived from fifty-year-olds over to an eighty-year-old. The predictors are the same as in SCORE2, plus diabetes: age, smoking, diabetes, systolic blood pressure, total and HDL cholesterol, each interacting with age. Almost all the interactions are negative, which reflects a familiar observation: with age the contribution of a single risk factor to relative risk falls even as absolute risk rises. The ESC 2021 thresholds for this age group are their own: below 7.5 % low to moderate risk, 7.5 to 15 % high, from 15 % very high. The calculation does not apply once cardiovascular disease is established. One more caveat: a high calculated risk at 80 does not by itself mean a statin should be started. That decision weighs life expectancy, comorbidity, the number of medicines already taken and what the patient wants.
Source
Formula version: score2-op-2021-suppl-table1-v1
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