SCORE2 Risk Categorisation — EECC MCQ
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Correct answer: E — For a 55-year-old, SCORE2 risk of 5-10% places him at high cardiovascular risk (age-calibrated threshold) — the LDL-C target is <1.8 mmol/L AND ≥50% reduction from baseline; statin therapy is recommended with ezetimibe added if needed
SCORE2 is used for apparently healthy people aged 40–69 years without established ASCVD. Its risk categories are age-calibrated. For someone aged 50–69 years, a 10-year SCORE2 risk of 5% to <10% is classified as high cardiovascular risk. Therefore, this 55-year-old man with a SCORE2 risk of 7% is high risk. The applicable LDL-C goal for high-risk patients is LDL-C <1.8 mmol/L and at least a 50% reduction from baseline. Management is lipid-lowering therapy, usually a maximally tolerated/high-intensity statin, with ezetimibe added if the LDL-C goal is not reached. The other options are incorrect because SCORE2 has not been replaced by Framingham in this framework, 7% is not low risk at age 55, LDL-C targets do differ by risk category, and high risk is not restricted to risks above 20%.
Reference: European Society of Cardiology. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. European Heart Journal 2021;42:3227–3337. https://academic.oup.com/eurheartj/article/42/34/3227/6358713