PHÂN TẦNG NGUY CƠ TIM MẠCH Ở CÁC NHÓM ĐỐI TƯỢNG KHÁC NHAU: NGƯỜI CÓ VẺ NGOÀI KHỎE MẠNH, ĐÁI THÁO ĐƯỜNG TÍP 2 VÀ BỆNH TIM MẠCH DO XƠ VỮA

Abstract

Background: Atherosclerotic cardiovascular disease is a leading cause of mortality. Cardiovascular risk stratification plays a key role in prevention, but data in Vietnam remain limited.

Objectives: (1) To stratify 10-year cardiovascular risk in apparently healthy individuals and patients with type 2 diabetes; (2) To assess residual cardiovascular risk in patients with established atherosclerotic cardiovascular disease.

Methods: A multicenter, cross-sectional study with longitudinal follow-up was conducted in 481 patients aged ≥ 40 years. Cardiovascular risk was assessed using SCORE2/SCORE2-OP in apparently healthy individuals, SCORE2-Diabetes in patients with type 2 diabetes, and SMART score in patients with atherosclerotic cardiovascular disease.

Results: In apparently healthy individuals, very high, high, and low–moderate risk accounted for 38.0%, 32.3%, and 29.7%, respectively; SCORE2 significantly increased the proportion of high and very high risk compared to SCORE. In type 2 diabetes, most patients were classified as very high risk (64.8%). Among patients with atherosclerotic cardiovascular disease, residual risk was mainly moderate (43.3%) and low (29.1%), but 13.5% remained at extremely high risk.

Conclusions: Contemporary risk models improve cardiovascular risk stratification across different patient groups. SCORE2 tends to classify more patients into higher risk categories, while patients with diabetes and established cardiovascular disease exhibit substantial residual risk, highlighting the need for continuous risk assessment and individualized management.