Sign in Subscribe
Cardiovascular diseases

New Tools for Quantifying Residual Risk in ASCVD Patients

Strategic Insights

— 1 min read

Despite advancements in treatment and prevention, patients with established atherosclerotic cardiovascular disease (ASCVD) still have a particularly high risk of having another heart attack, stroke, or other cardiovascular event. To address this, Mass General Brigham researchers developed and validated new tools for quantifying this "residual risk" in patients with prior myocardial infarction, stroke, coronary artery disease, peripheral arterial disease, transient ischemic attack, or arterial revascularization. The novel scoring tools substantially improved risk discrimination compared with the guidelines-recommended model.

Key Takeaways:

  • The new tools, RRS16 and RRS24, consider 16 and 24 different factors that can contribute to secondary risk, respectively, and require further validation in more diverse populations.
  • The models outperformed the American Heart Association guidelines and used readily available clinical factors and blood assays to get an improved risk estimate for patients with ASCVD.
  • The study was conducted using data from 32,994 United Kingdom Biobank participants and 54,969 Mass General Brigham participants, all with established ASCVD.
  • The models were developed and validated by researchers from Mass General Brigham, including lead author Olga Mineeva, PhD, who developed the models as part of her PhD thesis.
  • The models are intended for research only, but are currently free and accessible online.
  • Funding for the study was provided by the National Heart, Lung, and Blood Institute, the American Heart Association, and the Swiss Federal Institute of Technology, among others.
  • The study has been conducted using the UK Biobank Resource under Application Number 81959.

Statistics:

  • Approximately 26 million adults in the U.S. have ASCVD, which is a leading cause of death globally.
  • ASCVD contributes to 400,000 deaths in the U.S. every year.
  • The models were applied to data from 87,963 patients, who were followed for up to 10 years.
  • The RRS16 and RRS24 models had a c-statistic of 0.83 and 0.85, respectively, indicating that they had a better discriminatory power than the American Heart Association guidelines.
  • The models were able to predict 10-year cardiovascular death with a high degree of accuracy, particularly in patients with a history of myocardial infarction.

Sources:

  • Mineeva O, Demler O, Mora S. et al. "Development and Validation of Novel Residual Risk Scores for Patients With ASCVD." JACC DOI: 10.1016/j.jacadv.2025.102162
  • UK Biobank Resource. "Application Number 81959"
  • National Heart, Lung, and Blood Institute. "R21 HL156174"
  • American Heart Association. "17IGMV33860009"
  • Swiss Federal Institute of Technology. "ETH, Zurich, Switzerland"
  • National Human Genome Research Institute. "U01HG008685"

Read more