The SMART-REACH2 model was developed to provide individualized estimates of both short-term and lifetime risk of recurrent cardiovascular events while accounting for geographic differences in risk.
Investigators derived the model using data from 8,708 patients with established atherosclerotic cardiovascular disease (ASCVD) enrolled in the UCC-SMART cohort and externally validated it in more than 2 million patients from 54 countries. The findings were published in the European Heart Journal. The model predicts recurrent cardiovascular events, defined as myocardial infarction, stroke, or cardiovascular death, while also estimating the potential benefit of intensified preventive therapies.
Findings
- In the derivation cohort, 2,057 recurrent cardiovascular events occurred during a median follow-up of 8.5 years.
- External validation included 2,085,780 patients from 54 countries, among whom 307,706 recurrent cardiovascular events were recorded.
- The pooled C-statistic for prediction of recurrent cardiovascular events was 0.68 (95% CI, 0.66–0.69), ranging from 0.66 in low-risk European regions to 0.72 in Latin America.
- For a hypothetical 50-year-old patient, intensified prevention resulting in a 15 mmHg reduction in systolic blood pressure and a 1.0 mmol/L reduction in LDL cholesterol was associated with an estimated gain of 2.0 to 4.4 years of cardiovascular disease-free life expectancy.
The findings suggest that SMART-REACH2 provides reliable estimation of recurrent cardiovascular risk across diverse global populations and may facilitate personalized treatment discussions.
