Cardiology · 5 h ago
Retinal AI Modestly Reclassifies SCORE2 Cardiovascular Risk in UK Biobank
In a prospective UK Biobank cohort of 40,672 statin-naive adults without diabetes, a retinal AI risk score was evaluated alongside SCORE2 for 10-year ASCVD prediction. The score modestly reclassified participants across the ESC/EAS statin-indication boundary, but did not improve discrimination or net benefit; prospective validation is needed.
- Cohort included 40,672 statin-naive adults without diabetes.
- There were 914 ASCVD events over median 10-year follow-up.
- Reclassification was modest and did not improve net benefit.
- Authors say prospective validation is needed.
This prospective cohort study assessed whether a retinal artificial intelligence (AI) risk score could refine SCORE2-based 10-year atherosclerotic cardiovascular disease (ASCVD) risk estimates. It included 40,672 statin-naive UK Biobank participants aged 40–69 years without diabetes. Risk categories and statin-indication status were assigned using the 2025 ESC/EAS focused-update framework. Predictive performance was assessed with 10-fold cross-validation.
Over a median 10.0 years, 914 ASCVD events occurred. Compared with the low retinal AI risk group, the very high-risk group had a higher ASCVD risk after adjustment for SCORE2 (hazard ratio 2.32; p<0.001). Adding the AI score to SCORE2 produced statistically significant but modest reclassification across the statin-indication boundary (net reclassification improvement 0.012; p<0.001). It did not improve the C-index or net benefit. The score also stratified risk within the statin-indicated subgroup (adjusted hazard ratio 2.16; p<0.001).
The findings suggest potential for retinal AI to refine risk assessment, but do not establish that it should guide statin decisions. Reclassification was modest, and the authors call for prospective validation. The analysis was conducted in UK Biobank participants without diabetes, which may limit applicability to other populations.
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European Journal of Preventive Cardiology: Retinal Artificial Intelligence Reclassifies SCORE2-Based Cardiovascular Risk Across the ESC/EAS Statin-Indication Boundary: A UK Biobank Prospective Cohort Study ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.