SCORE2 EU-wide - Cardiovascular Risk Calculator 5 Regions ESC 2021 | Federico Calò
Estimate 10-year cardiovascular risk with SCORE2 and SCORE2-OP (ESC 2021) for all 5 European regions. Includes sample size calculator CRO (Fleiss). Calculations in browser - no data sent to server.
SCORE2 pan-EU extends the SCORE2 cardiovascular calculator (Moderate Region - Italy) to all 5 ESC 2021 risk regions: Low (IT, ES, FR, GR), Moderate (DE, AT, NL, SE), High (PL, HU, CZ, HR), Very high (BG, RO, RS, UA) and SCORE2-OP for patients aged 70 years or older. Each region uses different baseline survival S0 values and risk categorization thresholds calibrated to local cardiovascular mortality.
The model uses a multifactorial Cox approach with centered predictors: age, systolic blood pressure (SBP, mmHg), total cholesterol (TC, mmol/L) and smoking status. The linear model coefficients are the same in all regions for ESC 2021 [ASSUMED]; only the regional baseline survival constant S0 changes. The risk is calculated as 1 − S₀^exp(LP).
This tool also includes a sub-calculator CRO for sample size (Fleiss' z-test for two proportions), useful for planning two-arm clinical trials (control vs treatment) with configurable statistical power. All calculations are deterministic, performed in the browser, without AI.
Source: SCORE2 working group and ESC. Eur Heart J 2021;42:2439-2454 (DOI 10.1093/eurheartj/ehab309). CRO: Fleiss JL, Levin B, Paik MC. Statistical Methods for Rates and Proportions. 3rd ed. Wiley-Interscience, 2003.
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Example of calculation
Paziente tipo: Maschio, 58 anni, PAS 155 mmHg, TC 6.5 mmol/L, fumatore - confronto tra regione Moderata (DE) e Molto alta (BG).
- Moderate Region (DE): S0 = 0.9605 [ASSUMED] → risk estimated ~7-9%
- Very high region (BG): S0 = 0.8910 [ASSUMED] → estimated risk ~18–22%
- Heart risk difference reflects higher historical CVD mortality in high-risk areas.
- Approximate sample size: 294 arm (Corrected Fleiss: 309-315)
All values are assumed from training knowledge (ESC 2021) - verify against Supplementary Tables S1/S2/S3 before clinical use.
Vocabulary Dictionary
- Score 2 across EU
- Extension of the ESC 2021 model to all 5 European high-risk regions. Linear model coefficients are invariant by region; only the constant S0 survival baseline changes [ASSUMED].
- Base Survival Rate
- Probability of not having a cardiovascular event in the next 10 years in the target population of the region. Lower values indicate higher baseline risk. All values S0 in this tool are assumed.
- Test Z of Fleiss (CRO)
- Statistical method to calculate sample size in clinical studies with two proportions. The Fleiss continuity correction increases the estimated N to ensure nominal power in finished samples.
- Statistical power (1-β)
- Probability of detecting a real effect, if it exists. A study with an 80% power has a 20% risk of false negative (beta error). The 90% power requires larger samples but is more conservative.
Frequently Asked Questions
What is the difference between SCORE2 cardiovascular and SCORE2 pan-EU?
The SCORE2 Cardiovascular Calculator (Phase 52) uses only the Moderata region (Italy). The SCORE2 pan-EU adds the 5 high-risk regions from ESC 2021 (Low, Moderated, High, Very High, and SCORE2-OP for ≥70 years) with their respective S0 survival values and adjusted risk category thresholds.
How do I select the ESC region for a European patient?
Risk level depends on the patient's usual place of residence. Examples: Italy, Spain, France → Low risk; Germany, Netherlands, Sweden → Moderate risk; Poland, Hungary, Croatia → High risk; Bulgaria, Romania, Ukraine → Very high risk. For patients 70 years or older, use category "≥70 years (SCORE2-OP)" regardless of country. Always verify mapping on heartscore.org.
What is the size of the Cropped Rectangle and how do you use it?
Sample size calculator for a 2-arm clinical trial (control vs treatment) using the Fleiss z-test for two proportions. Enter the expected event rate (p₁), target proportion in the treatment group (p₂), significance level α, and desired statistical power. The result is the number of patients per group (with corrected Fleiss continuity correction).
Are your data secure?
Yes. All calculations occur locally in the browser - no clinical data is sent to external servers, AI, or third parties. The tool does not store or process personal or clinical data.
Can I use this tool for therapeutic decisions?
No. This tool is exclusively informative and NOT a medical device. The SCORE2 score is an aid to clinical decision-making that the doctor integrates with comprehensive evaluation. Values S0 and category thresholds [ASSUMED] are based on training knowledge ESC 2021 and require verification before real-world clinical use.
Why are constant SCORE2 values marked as [ASSUMED]?
Values S0 (basic survival) for the 5 ESC 2021 regions and category thresholds come from training knowledge of the ESC 2021 paper and require verification against Supplementary Table S1, S2, S3 before deployment to production. This transparency is part of the NORMATIVE_DATA_VERSION system implemented in this portfolio to ensure the reliability of normative data.
How is it used?
- Select the Risk Region
Choose the ESC 2021 region based on patient's place of residence. The 5 regions (Low, Moderate, High, Very High, ≥70 years) have constant S0 values that adjust risk to local cardiovascular mortality.
- Insert clinical data
Select biological sex, enter age (40-89 years), systolic blood pressure (mmHg), total cholesterol (mmol/L) and smoking status. The SCORE2 model applies to ages 40-69, SCORE2-OP to ages 70-89.
- Start calculation
Premi "Calculate risk SCORE2". All calculations occur in the browser - no clinical data is sent to the server.
- Interpret the result
The tool shows CVD risk at age 10 (%) and the ESC 2021 category calibrated for the selected region. Category limits vary by region. Always discuss results with your referring doctor.
Do you need a custom analysis?
This tool is free and informative. For in-depth analysis with AI on-prem - private data, zero cloud - contact Federico.