Comparative Profiling of QRISK3 and ASCVD Risk Scores in Indian Patients with Acute Cardiovascular Disease: A Cross-Sectional Study

Background: Cardiovascular disease (CVD) is a major public health burden in India. However, the applicability of Western cardiovascular risk prediction models such as QRISK3 and ASCVD remains uncertain due to genetic, lifestyle, and socioeconomic differences. Comparative evaluation of these models in Indian patients with acute cardiovascular disease remains limited. The aim is to compare QRISK3 and ASCVD risk score distribution and resultant statin eligibility among Indian patients presenting with acute cardiovascular disease. Material and Methods: A cross-sectional observational study was conducted at ESICMC and PGIMSR, Bangalore, India, including 95 participants aged 30–79 years with acute CVD (acute coronary syndrome, cerebrovascular accident, or peripheral vascular disease). QRISK3 and ASCVD 10-year risk scores were calculated using standardized online tools. Demographic, clinical, and laboratory parameters were collected. Statistical analysis included descriptive statistics, Chi-square tests, and ANOVA using IBM SPSS version 29.0. Results: The mean age was 57.13 ± 10.14 years and 77.9% were male. QRISK3 classified 47.4% of participants as high risk (>20%), whereas ASCVD classified 36.8% as high risk. Smoking and BMI showed significant associations with QRISK3 risk categories, while diabetes mellitus was significantly associated with ASCVD risk categories. No significant association was observed between blood pressure categories and either risk score. Statin eligibility differed between the models, with 87.4% eligible using QRISK3 compared with 77.9% using ASCVD thresholds. Conclusion: QRISK3 and ASCVD demonstrate differing patterns of cardiovascular risk stratification and statin eligibility in Indian patients with acute cardiovascular disease. These findings highlight limitations of applying Western-derived risk prediction models to South Asian populations and emphasize the need for population-specific cardiovascular risk assessment tools. Further validation in larger prospective cohorts is warranted.

Keywords: Risk stratification; Statin eligibility; Smoking; Obesity; Diabetes mellitus.