Heart failure (HF) represents a growing public health burden worldwide, highlighting the need for tools that can identify individuals at elevated risk before clinical onset. A recent study published in the European Heart Journal developed and validated SCORE2-HF, a model designed to estimate 10-year and 30-year risk of incident HF in European adults aged >40 years without prior cardiovascular disease (CVD).
The model was derived using pooled data from 25 prospective cohorts across 14 countries, including 611,778 individuals and 21,818 incident HF events. Sex-specific models adjusted for competing risks incorporated routinely available clinical variables: age, smoking status, systolic blood pressure (SBP), antihypertensive treatment, body mass index (BMI), estimated glomerular filtration rate (eGFR), and type 2 diabetes mellitus (T2DM), including age at diagnosis and glycated haemoglobin (HbA1c).
To ensure applicability across Europe, SCORE2-HF was recalibrated using World Health Organization (WHO) statistics and linked health records from five countries encompassing >36 million individuals and 515,466 HF events, reflecting contemporary HF incidence across four European risk regions.
External validation was conducted in three independent cohorts from three countries, comprising 1,336,824 participants and 36,841 HF events. Model discrimination demonstrated C-indices of 0.827 (95% CI 0.824–0.829), 0.839 (0.827–0.850), and 0.874 (0.863–0.884). Estimated HF risk varied substantially by risk factor burden and regional risk category.
For example, in low-risk regions, 70-year-old individuals with no adverse risk factors had a 10-year HF risk of 8% in men and 6% in women, compared with 24% and 20%, respectively, in those with four risk factors (smoking, T2DM, hypertension, BMI >30 kg/m²). In very high-risk regions, the estimated risk reached 59% in 70-year-old individuals with four adverse risk factors.
Overall, SCORE2-HF provides calibrated estimates of HF risk across European regions using routinely available clinical parameters. The model may enhance identification of individuals at higher risk of developing HF.
