Comparative Effectiveness of Risk Markers for Cardiovascular Risk Assessment in Intermediate-Risk Individuals: Coronary Artery Calcium vs "The Rest"?

Research output: Contribution to journalReview article

Abstract

The last decade has seen the emergence of a multitude of novel risk markers for coronary heart disease (CHD), ranging from genetic markers to serum biomarkers and imaging studies. Comparison between different risk markers has been historically difficult because of the paucity of high quality prospective studies evaluating these candidate risk markers side by side in the same population. In the last 2 years, several population based cohorts like MESA, Rotterdam, EISNER, and the Heinz Nixdorf Recall study have provided new data enabling assessment of comparative effectiveness for several of these risk markers. In this review, we evaluate evidence from these 4 large cohort studies regarding the relative improvement in the net reclassification index (NRI) among intermediate-risk patients. We conclude that CAC is the strongest marker for clinical risk prediction and is the most likely to positively influence downstream clinical outcomes.

Original languageEnglish (US)
Pages (from-to)203-210
Number of pages8
JournalCurrent Cardiovascular Imaging Reports
Volume6
Issue number3
DOIs
StatePublished - Jun 1 2013

Keywords

  • C-statistic
  • Cardiovascular risk models
  • Cardiovascular risk prediction
  • Coronary artery calcium
  • Coronary artery disease
  • Coronary artery disease risk prediction
  • Coronary heart disease
  • Intermediate risk
  • Net reclassification index
  • Primary prevention
  • Subclinical atherosclerosis

ASJC Scopus subject areas

  • Histology
  • Applied Microbiology and Biotechnology
  • Cell Biology

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