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July 12, 2026European Journal of Preventive CardiologyOpen Access

CUORE and SCORE2 provide moderate discrimination for 10-year MI or stroke risk in primary care.

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Why the study?

How do the CUORE and SCORE2 cardiovascular risk scores compare for 10-year prediction of first fatal or non-fatal myocardial infarction or stroke in an Italian primary care cohort?

Population

38,101 adults in an Italian primary care cohort (ATS Milan, baseline 2007-2009)

Comparison

CUORE cardiovascular risk score vs SCORE2 cardiovascular risk score

Design

Cohort

Follow-up

10 years

Key result

CUORE (AUC 0.730-0.741) and SCORE2 (AUC 0.713-0.720) provided moderate discrimination for 10-year risk of first fatal or non-fatal myocardial infarction or stroke in an Italian primary care cohort.

Authors

AMAlberto MilaneseARAntonio Russo

Discussion

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Overview

Both scores enable moderate discrimination and robust stratification in Italian primary care; leaves open optimal local recalibration and endpoint definitions before threshold-guided decisions.

Key Points

  • The study aims to validate and compare the CUORE and SCORE2 risk scores for predicting myocardial infarction or stroke in a primary care setting.
  • Analyzed data from 38,101 adults in ATS Milan with follow-up from 2007-2009.
  • Endpoints included first fatal or non-fatal myocardial infarction or stroke, using broad and strict administrative definitions.
  • Discrimination assessed with IPCW time-dependent AUC and calibration done with decile plots.
  • SCORE2 AUC ranged from 0.713 to 0.720, while CUORE ranged from 0.730 to 0.741.
  • Event rates showed broad ascertainment increased them: 5.6% for SCORE2 versus 4.4% for strict, and 6.8% for CUORE versus 5.0%.
  • SCORE2 exhibited more stable calibration, whereas CUORE showed calibration slopes less than 1.

Study Design

Type

Cohort (n=38,101)

Structured PICO

How do the CUORE and SCORE2 cardiovascular risk scores compare for 10-year prediction of first fatal or non-fatal myocardial infarction or stroke in an Italian primary care cohort?

P
Population
38,101 adults in an Italian primary care cohort followed for 10 years to validate cardiovascular risk scores.
E
Exposure
CUORE cardiovascular risk score
C
Comparator
SCORE2 cardiovascular risk score
O
Outcome
First fatal or non-fatal myocardial infarction or stroke at 10-year follow-upcomposite

Main Result

Effect estimate: AUC 0.730-0.741 (CUORE); AUC 0.713-0.720 (SCORE2)

Both CUORE and SCORE2 provide moderate discrimination for 10-year cardiovascular risk in an Italian primary care cohort, though absolute risk estimates are highly sensitive to administrative endpoint definitions and recalibration strategies.

Cite This Study

Milanese et al. (2026) conducted a cohort in Cardiovascular risk (n=38,101). CUORE and SCORE2 risk scores was evaluated on First fatal or non-fatal myocardial infarction or stroke (AUC 0.730-0.741 (CUORE); AUC 0.713-0.720 (SCORE2)). CUORE (AUC 0.730-0.741) and SCORE2 (AUC 0.713-0.720) provided moderate discrimination for 10-year risk of first fatal or non-fatal myocardial infarction or stroke in an Italian primary care cohort.

synapsesocial.com/papers/6a5334194f7abc118adee2f0https://doi.org/10.1093/eurjpc/zwag361
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