Cardiovascular Risk Assessment Scores: Key Points

1.   Framingham Risk Score

1. 1. This risk score helps to estimate the patient’s risk in 10 years for developing myocardial infarction and cardiac death by involving all the risk factors such as age, total cholesterol, hypertension, gender, high-density lipoprotein, and smoking habits
   2. The recommended LDL cholesterol goal for individuals with an FRS of 10%–20% (intermediate risk) is < 130 mg/dL. Those at low risk are advised to have an FRS of < 10%
   3. The FRS, being a 10-year model, is perfect for determining which patients are more vulnerable to incident coronary events in the short term, but it is not a good indicator of the long-term risk of coronary disease or the impact of exposure to risk factors over time, especially in younger patients
   4. It is commonly acknowledged that a family history of early CHD increases the likelihood of developing CHD, but another limitation of the FRS is that it does not take into account other possible coronary disease risk factors, like a family history of early CHD

3.  QRISK Score

1. A method developed in the UK that takes into account variables including gender, age, ethnicity, cholesterol, blood pressure, smoking habits, diabetes, and family history to estimate the 10-year risk of getting CVD
2. Hypertension along with socioeconomic level, atrial fibrillation, family history of ASCVD, rheumatoid arthritis, and body mass index characteristics are included in this risk score
3. QRISK3 also includes factors such as the use of atypical antipsychotic drugs and corticosteroids and severe psychiatric conditions such as bipolar disorder and schizophrenia. It also helps in assessing risk in patients with SLE, inflammatory bowel diseases, and Type 2 diabetes mellitus
4. QRISK3 is considered the best method for assessing cardiovascular risk according to a study done by Garg et al. There is also an option to choose “Indian” as an ethnicity in the QRISK tool
5. QRISK 2 —TAKES SMOKELESS TOBACCO INTO CONSIDERATION.

4.  Reynolds Risk Score

1. Like the FRS, the Reynolds risk score takes C-reactive protein, an indicator of inflammation and parental history, along with the other risk factors into account. Using this score, it is found that approximately 30% of initially healthy women labeled as “intermediate risk” may be more accurately recategorized into higher- or lower-risk groups

5.  Assessing Cardiovascular Risk Using Sign Risk Score(ASSIGN)

1. This UK-based risk assessment score, ASSIGN (assessing cardiovascular risk using SIGN [Scottish Intercollegiate Guidelines Network] guidelines to ASSIGN preventive management) includes social deprivation in its risk model
2. When the ASSIGN risk score was compared to the FRS, which only included conventional risk factors, it showed a slight improvement in risk estimation. The first cardiovascular risk score that was created to include lower socioeconomic strata as a variable to achieve equality for lower-class individuals is the ASSIGN risk score

6.  Joint British Society Calculator 3 Risk Calculator

1. This score uses both typical and nontypical factors to assess short-term (10-year) and long-term cardiovascular risk. This score helps in identifying and assessing patients in whom pharmacological treatment is not beneficial and CVD risk can be prevented by diet, behavioral, and lifestyle modifications.
2. The factors included in the Joint British Society Calculator 3 (JBS3) are heart age , event free survival , age adjusted the survival rate of a person free of CVD and Risk score manipulation
3. The risk assessment scores that are best for the Indian population are FRS, QRISK3, and JBS depending on the risk factors present among individuals. The FRS and QRISK3 are considered useful in assessing cardiovascular risk in patients who are eligible for statin therapy
4. Currently, the best risk assessment tool used for the Indian population who are at risk of developing atherosclerosis is the JBS risk score according to a study done by Bansal et al