Table 1

Comparison of ASCVD Risk Assessment Tools

SourceRecommended Risk Assessment ToolForecast Capability of Tool (yrs)Risk Factors Included for Risk EstimationAtherosclerotic Cardiovascular Disease Outcome PredictedPopulation Used for Derivation/Validation of Risk Algorithm
National Cholesterol Education Program Adult Treatment Panel III (7,8)Original Framingham Risk Score (9)10Sex, age, TC, HDL-C, blood pressure, diabetes, smoking statusMyocardial infarction and coronary heart disease death• Framingham original and offspring cohorts
• Men, n = 2,489
• Women, n = 2,856
• Ages 30−74 yrs
• Caucasian
International Atherosclerosis Society (16)Updated Framingham Risk Score (17) with recalibration coefficients for different patient populationsLifetimeRisk factor status age 50 yrs: TC, systolic blood pressure, diastolic blood pressure, smoking status, diabetesMyocardial infarction, coronary insufficiency, angina, stroke, claudication, CVD death based on measured risk factors at age 50 yrs• Framingham original and offspring cohorts
• Men, n = 3,564
• Women, n = 4,362
• Ages 30−74 yrs
• Caucasian
European Society of Cardiology/European Atherosclerosis Society (22)SCORE (23)
Systematic Coronary Risk Evaluation (with risk adjustment algorithm/tables provided based on population/country)
10TC or TC/HDL-C ratio, sex, smoking status, systolic blood pressureFatal atherosclerotic event (myocardial infarction, stroke, occlusive arterial disease, sudden cardiac death)• 104,961 subjects from 7 pooled European (Belgium, Britain, Denmark, Finland, Germany, Italy, Spain) prospective studies
• Men, 55% (ages 20−89 yrs)
• Women, 45% (ages 20−99 yrs)
Canadian Cardiovascular Society (27)Framingham Risk Score: Global Cardiovascular Disease Risk (29)10Age, sex, TC, HDL-C, systolic blood pressure, blood pressure treatment, smoking status, diabetes, vascular ageAbsolute ASCVD event (coronary heart, cerebrovascular, peripheral vascular, and heart failure)• Framingham original and offspring cohorts
• Men, n = 3,969
• Women, n = 4,522
• Ages 30−74 yrs
• Caucasian
Modified Framingham Risk Score (multiply score by 2 in presence of family history of premature ASCVD) (27)
American Association of Clinical Endocrinologists (30)Men:
Original Framingham Risk Score (9) Adult Treatment Panel III
10Sex, age, TC, HDL-C, blood pressure, diabetes, smoking statusFramingham Risk Score: Myocardial infarction and coronary heart disease deathFramingham original and offspring cohorts
• Men, n = 2,489
• Women, n = 2,856
• Ages 30–74 yrs
• Caucasian
Women:
Reynolds Risk Score (32,33)
10Age, systolic blood pressure, HgbA1C if diabetic, current smoking, TC, HDL-C, hs-CRP, family history premature ASCVDReynolds Risk Score: Myocardial infarction, ischemic stroke, coronary revascularization, and cardiovascular death• Women's Health Study
• Women, n = 24,558
• Ages 48−59 yrs
• Caucasian = 95%
• Black = 1.9%
• Asian = 1.4%
Kidney Disease:
Improving Global Outcomes: Clinical Practice Guideline for Lipid Management in Chronic Kidney Disease (41)
Kidney Disease: Improving Global Outcomes Coronary Risk Assessment (45)10Age, estimated glomerular filtration rateMyocardial infarction or coronary heart death by age and estimated glomerular filtration rate• Alberta Kidney Disease Network
• N = 1,268,029
• Women, 50%
• Mean age = 49.4 yrs
Effectiveness-Based Guidelines for the Prevention of Cardiovascular Disease in Women—2011 Update (37)Framingham Risk Score: Global Cardiovascular Disease Risk (19)10Age, sex, TC, HDL-C, systolic blood pressure, blood pressure treatment, smoking status, diabetesFramingham Risk Score: Absolute ASCVD event (coronary heart, cerebrovascular, peripheral vascular, and heart failure)Framingham original and offspring cohorts
• Men, n = 3,969
• Women, n = 4,522
• Ages 30−74 yrs
• Caucasian
Reynolds Risk Score (32,33)10Age, sex, systolic blood pressure, HgbA1C if diabetic, current smoking, TC, HDL-C, hs-CRP, family history premature ASCVDReynolds Risk Score: Myocardial infarction, ischemic stroke, coronary revascularization, and cardiovascular death• Women's Health Study
• Women, n = 24,558
• Ages 48−59 yrs
• Caucasian = 95%
• Black = 1.9%
• Asian = 1.4%
2013 American College of Cardiology/American Heart Association Guidelines on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults (50)Cardiovascular Risk Calculator based on Pooled Cohort Risk Equations (52)10
Lifetime or 30 (for ages 20−59 yrs)
Age, sex, ethnicity (Caucasian or African American), TC, HDL-C, systolic blood pressure, treatment for hypertension, diabetesNonfatal myocardial infarction, coronary heart disease death, fatal or nonfatal stroke• Atherosclerosis Risk in Communities
• Cardiovascular Health Study
• Coronary Artery Risk Development in Young Adults
• Framingham Original and Offspring Studies
• African American, white men and women
• Ages 40−74 yrs

ASCVD = atherosclerotic cardiovascular disease; CVD = cardiovascular disease; HDL-C = high-density lipoprotein cholesterol; HgbA1C = hemoglobin A1C; hs-CRP = high-sensitivity C-reactive protein; TC = total cholesterol.