Comparative assessment of cardiovascular risk in European and Korean ethnic groups in the Russian population using the SCORE and SCORE2

Aim. To carry out a comparative assessment of cardiovascular risk (CVR) in people aged 40-49 years of European and Korean ethnicity with a single residence area using the Systematic Coronary Risk Evaluation (SCORE) and SCORE2 scales.

Material and methods. We examined 397 and 50 apparently healthy individuals of the European (EEG) and Korean (KEG) ethnic groups, respectively, who were evaluated for CVR according to the SCORE and SCORE2 charts.

Results. According to the SCORE system, the median CVR in the EEG was 0 [0-0] vs 0 [0-1]% in the KEG (p<0,001), while from a clinical point of view, the groups did not differ from each other. The SCORE2 system demonstrated more significant clinical results as follows: the median risk in EEG individuals was 5 [3-8]%, which corresponds to a high CVR for this age group, and 8 [4-11]% in KEG individuals, which corresponds to a very high CVR (p=0,011). CVR assessment in apparently healthy individuals is decisive in considering the preventive measures. According to the SCORE system, 97,5% and 96% of apparently healthy EEG and KEG individuals, respectively, are classified as low and moderate risk. High and very high risk when using this system was determined in 2,5 and 4% among Europeans and Koreans, respectively. However, using the SCORE2 system, only 10,3% of Europeans were classified as low/ moderate risk, and among ethnic Koreans — 8%. At the same time, the category of high and very high risk was designated, respectively, for 63,7 and 25,9% in the EEG and 40 and 52% in the KEG, respectively. It has been established that according to the SCORE2 system, more than half of Koreans aged 40-49 already have a very high CVR, which significantly distinguishes this group from the European population.

Conclusion. The SCORE2 system has a more differentiated approach in determining individual CVR. The SCORE2 assessment of non-high density lipoprotein cholesterol levels makes it more personalized for use in different ethnic populations.

1. Andrea B., Alberto A, Vincenzo C, et al. Cardiovascular disease and COVID-19: les liaisons dangereuses. Eur J Prev Cardiol. 2020;(10):1017-25. doi:10.1177/2047487320924501.

2. Cardiovascular prevention 2017. National guidelines. Russian Journal of Cardiology. 2018;(6):7-122. (In Russ.) doi:10.15829/1560-4071-2018-6-7-122.

3. Belov YuS, Tkachenko AV. Intellectual systems in predicting cardiovascular diseases. Software products, systems and algorithms. 2019;(2):12-6. (In Russ.) doi:10.15827/2311-6749.19.2.3.

4. Kukharchuk VV, Ezhov MV, Sergienko IV, et al. Diagnostics and correction of lipid metabolism disorders in order to prevent and treat of atherosclerosis Russian recommendations VII revision. Journal of atherosclerosis and dyslipisemias. 2020;11(1):38. (In Russ.) doi:10.34687/2219-8202.JAD.2020.01.0002.

5. Visseren FLJ, Mach F, Smulders YM, et al. 2021 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. 2021;42(34):3227-37. doi:10.1093/eurheartj/ehab484.

6. SCORE2 working group and ESC Cardiovascular risk collaboration. SCORE2 risk prediction algorithms: new models to estimate 10-year risk of cardiovascular disease in Europe. Eur Heart J. 2021;13:ehab309. doi:10.1093/eurheartj/ehab309.

7. Muromtseva GA, Kontsevaya AV, Konstantinov VV, et al. The prevalence of noninfectious diseases risk factors in Russian population in 2012-2013 years. The results of ESSE-RF. Cardiovascular Therapy and Prevention. 2014;13(6):4-11. (In Russ.) doi:10.15829/1728-8800-2014-6-4-11.

8. Bogdanov DYu, Nevzorova VA, Shumatov VB, et al. Risk factors for cardiovascular disease in ethnic Europeans and Koreans living in the Primorsky Krai. Cardiovascular Therapy and Prevention. 2020;19(1):40-7. (In Russ.) doi:10.15829/1728-8800-2020-1-2284.

9. Shalnova SA, Vilkov VG, Metelskaya VA, et al. Thirty-Year Changes in Average Blood Lipids Levels in Populations of the Russian Federation and the USA. Rational Pharmacotherapy in Cardiology. 2018;14(1):4-11. (In Russ). doi:10.20996/1819-6446-2018-14-1-4-11.

10. Hariyanto TI, Kurniawan A. Dyslipidemia is associated with severe coronavirus disease 2019 (COVID-19) infection. Diabetes Metab Syndr. 2020;14(5):1463-5. doi:10.1016/j.dsx.2020.07.054.

11. Cao X, Yin R, Albrecht H, et al. Cholesterol: A new game player accelerating vasculopathy caused by SARS-CoV-2? Am J Physiol Endocrinol Metab. 2020;319(1):197-202. doi:10.1152/ajpendo.00255.2020.

12. Mach F, Baigent C, Catapano AL, et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J. 2020;41(1):111-88. doi:10.1093/eurheartj/ehz455.

13. Carr SS, Hooper AJ, Sullivan DR, Burnett JR. Non-HDLcholesterol and apolipoprotein B compared with LDLcholesterol in atherosclerotic cardiovascular disease risk assessment. Pathology. 2019;51(2):148-54. doi:10.1016/j.pathol.2018.11.006.

14. Puri R, Nissen SE, Shao M, et al. Non-HDL Cholesterol and Triglycerides: Implications for Coronary Atheroma Progression and Clinical Events. Arterioscler Thromb Vasc Biol. 2016;36(11):2220-8. doi:10.1161/ATVBAHA.116.307601.

15. Gazzola K, Reeskamp L, van den Born BJ. Ethnicity, lipids and cardiovascular disease. Curr Opin Lipidol. 2017;28(3):225-30. doi:10.1097/MOL.0000000000000412.

16. Gazzola K, Snijder MB, Hovingh GK, et al. Ethnic differences in plasma lipid levels in a large multiethnic cohort: The HELIUS study. J ClinLipidol. 2018;12(5):1217-24.e1. doi:10.1016/j.jacl.2018.06.015.