10-Year ASCVD Risk Score

Introduction

Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality worldwide. Atherosclerotic cardiovascular disease (ASCVD), a subset of CVD, includes conditions such as coronary artery disease, stroke, and peripheral arterial disease. Screening for ASCVD is critical in identifying individuals at high risk for cardiovascular events and implementing preventive strategies to reduce the incidence of these conditions.

The American College of Cardiology / American Heart Association (ACC/AHA) ASCVD Risk Estimator is a widely recognized tool used to estimate an individual’s risk of developing ASCVD. The tool takes into account various factors, including age, sex, race, cholesterol levels, blood pressure, diabetes, and smoking status, to provide a comprehensive risk assessment. By accurately identifying high-risk patients, healthcare providers can tailor interventions, such as lifestyle modifications and pharmacotherapy, to effectively manage and mitigate the risk of ASCVD.

The 10-year ASCVD risk score that is produced by the ACC/AHA ASCVD Risk Estimator is integrated into the Relevant platform. Incorporating the ASCVD risk score into routine clinical practice enables community health centers to enhance their preventive care strategies, improve patient outcomes, and meet the reporting requirements for the CMS347 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease quality measure. This measure requires the identification and appropriate management of patients at high risk for cardiovascular events, making the use of the 10-year ASCVD risk score an essential component of comprehensive cardiovascular care.

How Does It Work?

Relevant’s built-in 10-Year ASCVD Risk Score is calculated using the Pooled Cohort Equations from the 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk. The following Data Elements are required:

  • Lab Results must have quantitative_result mapped
  • Total Cholesterol Labs
  • HDL Labs
  • Anti-Hypertensive Medications
  • Blood Pressure Readings
  • Tobacco Use Screens
  • Diabetes Cases
  • Patients
  • Races

The most recent entries in these Data Elements are used to calculate the risk score.

Configuration

The risk score can be enabled in the Data Pipeline under Risk Models. It is necessary to configure the risk levels, which are defined by the ACC/AHA as follows:

  • Low Risk: <5%
  • Borderline Risk: 5%-7.5%
  • Intermediate Risk: 7.5%-20%
  • High Risk: ≥20%

When enabled, the risk score will show for age-appropriate patients in the Visit Planning module. This visibility allows healthcare providers to quickly identify high-risk individuals during routine visits and make informed decisions regarding their care. Patients with a 10-year ASCVD risk score ≥20% should have the score entered into the EHR, at least annually, so the patient can be appropriately included in the denominator of the Statin Therapy quality measure along with patients with clinical ASCVD, those with LDL-C levels ≥190 mg/dL, and patients aged 40-75 with diabetes.