SMART2 Risk Score for Recurrent Vascular Events
Second Manifestations of ARTerial disease (SMART) risk score. Predicts 10-year risk of recurrent cardiovascular events in patients with established atherosclerotic vascular disease.
Score interpretation
SMART2 10-year recurrent ASCVD risk below 10 %.
→ Continue secondary prevention.
SMART2 10-year risk 10–20 %.
→ Optimise risk factors to target.
SMART2 10-year risk 20–30 %.
→ Intensify secondary prevention; consider additional therapies.
SMART2 10-year risk 30 % or more.
→ Intensify secondary prevention; specialist review.
Interpretation bands for the SMART Risk Score. Apply clinical judgement and local guidance.
References
- Hageman SHJ, et al. Estimation of recurrent atherosclerotic cardiovascular event risk in patients with established cardiovascular disease: the updated SMART2 algorithm. Eur Heart J. 2022;43(18):1715–1727.
Related
Curated clinical cross-links plus same-class fallbacks.
- Framingham Risk Score · Cardiovascular Risk
- ACC/AHA Pooled Cohort Equations — ASCVD Risk · Cardiovascular Risk
- PREVENT Cardiovascular Risk Calculator (AHA/ACC 2023) · Cardiovascular Risk
- Reynolds Risk Score for Women · Cardiovascular Risk
- SCORE2 — 10-Year CVD Risk (Age 40–69) · Cardiovascular Risk
- SCORE2-OP — 5/10-Year CVD Risk (Age ≥ 70) · Cardiovascular Risk
- Clopidogrel (Stroke/TIA Secondary Prevention) · Antiplatelet (P2Y12 Inhibitor)
- Dipyridamole (Secondary Stroke Prevention) · Antiplatelet — Phosphodiesterase Inhibitor / Adenosine Uptake Inhibitor
- Evolocumab · PCSK9 inhibitor monoclonal antibody
- Acetazolamide (Ménière's Disease) · Carbonic Anhydrase Inhibitor (Diuretic)
- Inclisiran · PCSK9 Inhibitor (siRNA — Small Interfering RNA)
- Evolocumab · PCSK9 Inhibitor (Monoclonal Antibody)
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.