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Published in: Journal of Nuclear Cardiology 6/2020

01-12-2020 | Editorial

Cardiovascular risk assessment models: Have we found the perfect solution yet?

Authors: Aiden Abidov, MD, PhD, Omar Chehab, MD, MSc

Published in: Journal of Nuclear Cardiology | Issue 6/2020

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Excerpt

Despite technical and pharmaceutical advancements and achievements in the last two decades and some decrease in overall mortality rate from cardiovascular disease (CVD), it remains the leading cause of death and economic burden.1
Literature
1.
go back to reference Benjamin EJ, et al. Heart disease and stroke statistics-2018 update: A report From the American Heart Association. Circulation 2018;137:e67-492.PubMed Benjamin EJ, et al. Heart disease and stroke statistics-2018 update: A report From the American Heart Association. Circulation 2018;137:e67-492.PubMed
2.
go back to reference Frohlich ED, Quinlan PJ. Coronary heart disease risk factors: Public impact of initial and later-announced risks. Ochsner J 2014;14:532-7.PubMedPubMedCentral Frohlich ED, Quinlan PJ. Coronary heart disease risk factors: Public impact of initial and later-announced risks. Ochsner J 2014;14:532-7.PubMedPubMedCentral
3.
go back to reference Willadsen TG, et al. The role of diseases, risk factors and symptoms in the definition of multimorbidity: A systematic review. Scand J Prim Health Care 2016;34:112-21.PubMedPubMedCentral Willadsen TG, et al. The role of diseases, risk factors and symptoms in the definition of multimorbidity: A systematic review. Scand J Prim Health Care 2016;34:112-21.PubMedPubMedCentral
4.
go back to reference Yusuf S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): Case-control study. Lancet 2004;364:937-52.PubMed Yusuf S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): Case-control study. Lancet 2004;364:937-52.PubMed
5.
go back to reference Hobbs FD, et al. Barriers to cardiovascular disease risk scoring and primary prevention in Europe. QJM 2010;103:727-39.PubMed Hobbs FD, et al. Barriers to cardiovascular disease risk scoring and primary prevention in Europe. QJM 2010;103:727-39.PubMed
6.
go back to reference Graham I, et al. European guidelines on cardiovascular disease prevention in clinical practice: Full text. Fourth Joint Task Force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts). Eur J Cardiovasc Prev Rehabil 2007;14:S1-113.PubMed Graham I, et al. European guidelines on cardiovascular disease prevention in clinical practice: Full text. Fourth Joint Task Force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts). Eur J Cardiovasc Prev Rehabil 2007;14:S1-113.PubMed
7.
go back to reference British Cardiac S, et al. JBS 2: Joint British Societies’ guidelines on prevention of cardiovascular disease in clinical practice. Heart 2005;91:v1-52. British Cardiac S, et al. JBS 2: Joint British Societies’ guidelines on prevention of cardiovascular disease in clinical practice. Heart 2005;91:v1-52.
9.
go back to reference Kurian AK, Cardarelli KM. Racial and ethnic differences in cardiovascular disease risk factors: A systematic review. Ethn Dis 2007;17:143-52.PubMed Kurian AK, Cardarelli KM. Racial and ethnic differences in cardiovascular disease risk factors: A systematic review. Ethn Dis 2007;17:143-52.PubMed
10.
go back to reference Gilstrap LG, Wang TJ. Biomarkers and cardiovascular risk assessment for primary prevention: An update. Clin Chem 2012;58:72-82.PubMed Gilstrap LG, Wang TJ. Biomarkers and cardiovascular risk assessment for primary prevention: An update. Clin Chem 2012;58:72-82.PubMed
11.
go back to reference Vasan RS. Biomarkers of cardiovascular disease: Molecular basis and practical considerations. Circulation 2006;113:2335-62.PubMed Vasan RS. Biomarkers of cardiovascular disease: Molecular basis and practical considerations. Circulation 2006;113:2335-62.PubMed
12.
go back to reference Jin J. Risk assessment for cardiovascular disease with nontraditional risk factors. JAMA 2018;320:316.PubMed Jin J. Risk assessment for cardiovascular disease with nontraditional risk factors. JAMA 2018;320:316.PubMed
13.
go back to reference Bonner C, et al. Clinical validity, understandability, and actionability of online cardiovascular disease risk calculators: Systematic review. J Med Internet Res 2018;20:e29.PubMedPubMedCentral Bonner C, et al. Clinical validity, understandability, and actionability of online cardiovascular disease risk calculators: Systematic review. J Med Internet Res 2018;20:e29.PubMedPubMedCentral
14.
go back to reference Beswick AD, et al. A systematic review of risk scoring methods and clinical decision aids used in the primary prevention of coronary heart disease (supplement). London: Royal College of General Practitioners; 2008. Beswick AD, et al. A systematic review of risk scoring methods and clinical decision aids used in the primary prevention of coronary heart disease (supplement). London: Royal College of General Practitioners; 2008.
15.
go back to reference Naghavi M, et al. From vulnerable plaque to vulnerable patient: Part III: Executive summary of the Screening for Heart Attack Prevention and Education (SHAPE) Task Force report. Am J Cardiol 2006;98:2H-15H.PubMed Naghavi M, et al. From vulnerable plaque to vulnerable patient: Part III: Executive summary of the Screening for Heart Attack Prevention and Education (SHAPE) Task Force report. Am J Cardiol 2006;98:2H-15H.PubMed
16.
go back to reference Shaw LJ, et al. A primer of biostatistic and economic methods for diagnostic and prognostic modeling in nuclear cardiology: Part II. J Nucl Cardiol 1997;4:52-60.PubMed Shaw LJ, et al. A primer of biostatistic and economic methods for diagnostic and prognostic modeling in nuclear cardiology: Part II. J Nucl Cardiol 1997;4:52-60.PubMed
17.
go back to reference Shaw LJ, et al. A primer of biostatistic and economic methods for diagnostic and prognostic modeling in nuclear cardiology: Part I. J Nucl Cardiol 1996;3:538-45.PubMed Shaw LJ, et al. A primer of biostatistic and economic methods for diagnostic and prognostic modeling in nuclear cardiology: Part I. J Nucl Cardiol 1996;3:538-45.PubMed
18.
go back to reference Abidov A, Raff GL. Value of coronary CTA in patients with known or suspected CAD and non-diagnostic initial myocardial perfusion testing: Current evidence and clinical considerations. J Nucl Cardiol 2010;17:1101-6.PubMed Abidov A, Raff GL. Value of coronary CTA in patients with known or suspected CAD and non-diagnostic initial myocardial perfusion testing: Current evidence and clinical considerations. J Nucl Cardiol 2010;17:1101-6.PubMed
20.
go back to reference Betancur J, et al. Prognostic value of combined clinical and myocardial perfusion imaging data using machine learning. JACC Cardiovasc Imaging 2018;11:1000-9.PubMed Betancur J, et al. Prognostic value of combined clinical and myocardial perfusion imaging data using machine learning. JACC Cardiovasc Imaging 2018;11:1000-9.PubMed
21.
go back to reference Koh AS, et al. Differential risk reclassification improvement by exercise testing and myocardial perfusion imaging in patients with suspected and known coronary artery disease. J Nucl Cardiol 2016;23:366-78.PubMed Koh AS, et al. Differential risk reclassification improvement by exercise testing and myocardial perfusion imaging in patients with suspected and known coronary artery disease. J Nucl Cardiol 2016;23:366-78.PubMed
22.
go back to reference Shaw LJ, et al. Improved near-term coronary artery disease risk classification with gated stress myocardial perfusion SPECT. JACC Cardiovasc Imaging 2010;3:1139-48.PubMed Shaw LJ, et al. Improved near-term coronary artery disease risk classification with gated stress myocardial perfusion SPECT. JACC Cardiovasc Imaging 2010;3:1139-48.PubMed
23.
go back to reference Osawa K, Nakanishi R, Budoff M. Coronary artery calcification. Glob Heart 2016;11:287-93.PubMed Osawa K, Nakanishi R, Budoff M. Coronary artery calcification. Glob Heart 2016;11:287-93.PubMed
24.
go back to reference Detrano R, et al. Coronary calcium as a predictor of coronary events in four racial or ethnic groups. N Engl J Med 2008;358:1336-45.PubMed Detrano R, et al. Coronary calcium as a predictor of coronary events in four racial or ethnic groups. N Engl J Med 2008;358:1336-45.PubMed
25.
go back to reference Lakoski SG, et al. Coronary artery calcium scores and risk for cardiovascular events in women classified as “low risk” based on Framingham risk score: The multi-ethnic study of atherosclerosis (MESA). Arch Intern Med 2007;167:2437-42.PubMed Lakoski SG, et al. Coronary artery calcium scores and risk for cardiovascular events in women classified as “low risk” based on Framingham risk score: The multi-ethnic study of atherosclerosis (MESA). Arch Intern Med 2007;167:2437-42.PubMed
26.
go back to reference Pencina MJ, D’Agostino RB Sr, Steyerberg EW. Extensions of net reclassification improvement calculations to measure usefulness of new biomarkers. Stat Med 2011;30:11-21.PubMed Pencina MJ, D’Agostino RB Sr, Steyerberg EW. Extensions of net reclassification improvement calculations to measure usefulness of new biomarkers. Stat Med 2011;30:11-21.PubMed
27.
go back to reference Pencina MJ, et al. Evaluating the added predictive ability of a new marker: From area under the ROC curve to reclassification and beyond. Stat Med 2008;27:157-72 (discussion 207-12).PubMed Pencina MJ, et al. Evaluating the added predictive ability of a new marker: From area under the ROC curve to reclassification and beyond. Stat Med 2008;27:157-72 (discussion 207-12).PubMed
28.
go back to reference Hlatky MA, et al. Criteria for evaluation of novel markers of cardiovascular risk: A scientific statement from the American Heart Association. Circulation 2009;119:2408-16.PubMedPubMedCentral Hlatky MA, et al. Criteria for evaluation of novel markers of cardiovascular risk: A scientific statement from the American Heart Association. Circulation 2009;119:2408-16.PubMedPubMedCentral
29.
go back to reference Karlamangla AS, et al. Socioeconomic and ethnic disparities in cardiovascular risk in the United States, 2001-2006. Ann Epidemiol 2010;20:617-28.PubMedPubMedCentral Karlamangla AS, et al. Socioeconomic and ethnic disparities in cardiovascular risk in the United States, 2001-2006. Ann Epidemiol 2010;20:617-28.PubMedPubMedCentral
30.
go back to reference Hunt KJ, et al. All-cause and cardiovascular mortality among Mexican-American and non-Hispanic White older participants in the San Antonio Heart Study-evidence against the “Hispanic paradox”. Am J Epidemiol 2003;158:1048-57.PubMed Hunt KJ, et al. All-cause and cardiovascular mortality among Mexican-American and non-Hispanic White older participants in the San Antonio Heart Study-evidence against the “Hispanic paradox”. Am J Epidemiol 2003;158:1048-57.PubMed
31.
go back to reference Mensah GA, et al. State of disparities in cardiovascular health in the United States. Circulation 2005;111:1233-41.PubMed Mensah GA, et al. State of disparities in cardiovascular health in the United States. Circulation 2005;111:1233-41.PubMed
32.
go back to reference Meadows TA, et al. Ethnic differences in cardiovascular risks and mortality in atherothrombotic disease: Insights from the Reduction of Atherothrombosis for Continued Health (REACH) registry. Mayo Clin Proc 2011;86:960-7.PubMedPubMedCentral Meadows TA, et al. Ethnic differences in cardiovascular risks and mortality in atherothrombotic disease: Insights from the Reduction of Atherothrombosis for Continued Health (REACH) registry. Mayo Clin Proc 2011;86:960-7.PubMedPubMedCentral
33.
go back to reference Rana JS, et al. Accuracy of the atherosclerotic cardiovascular risk equation in a large contemporary, multiethnic population. J Am Coll Cardiol 2016;67:2118-30.PubMedPubMedCentral Rana JS, et al. Accuracy of the atherosclerotic cardiovascular risk equation in a large contemporary, multiethnic population. J Am Coll Cardiol 2016;67:2118-30.PubMedPubMedCentral
34.
go back to reference Jr. Smith SC, Grundy SM. ACC/AHA guideline recommends fixed-dose strategies instead of targeted goals to lower blood cholesterol. J Am Coll Cardiol 2014;64:601-12.PubMed Jr. Smith SC, Grundy SM. ACC/AHA guideline recommends fixed-dose strategies instead of targeted goals to lower blood cholesterol. J Am Coll Cardiol 2014;64:601-12.PubMed
35.
go back to reference Cook NR, Ridker PM. Further insight into the cardiovascular risk calculator: The roles of statins, revascularizations, and underascertainment in the Women’s Health Study. JAMA Intern Med 2014;174:1964-71.PubMedPubMedCentral Cook NR, Ridker PM. Further insight into the cardiovascular risk calculator: The roles of statins, revascularizations, and underascertainment in the Women’s Health Study. JAMA Intern Med 2014;174:1964-71.PubMedPubMedCentral
36.
go back to reference Ridker PM, Cook NR. Statins: New American guidelines for prevention of cardiovascular disease. Lancet 2013;382:1762-5.PubMed Ridker PM, Cook NR. Statins: New American guidelines for prevention of cardiovascular disease. Lancet 2013;382:1762-5.PubMed
37.
go back to reference DeFilippis AP, et al. An analysis of calibration and discrimination among multiple cardiovascular risk scores in a modern multiethnic cohort. Ann Intern Med 2015;162:266-75.PubMedPubMedCentral DeFilippis AP, et al. An analysis of calibration and discrimination among multiple cardiovascular risk scores in a modern multiethnic cohort. Ann Intern Med 2015;162:266-75.PubMedPubMedCentral
38.
go back to reference Yadlowsky S, et al. Clinical implications of revised pooled cohort equations for estimating atherosclerotic cardiovascular disease risk. Ann Intern Med 2018;169:20-9.PubMed Yadlowsky S, et al. Clinical implications of revised pooled cohort equations for estimating atherosclerotic cardiovascular disease risk. Ann Intern Med 2018;169:20-9.PubMed
39.
go back to reference Slomka PJ, et al. Cardiac imaging: Working towards fully-automated machine analysis and interpretation. Expert Rev Med Devices 2017;14:197-212.PubMedPubMedCentral Slomka PJ, et al. Cardiac imaging: Working towards fully-automated machine analysis and interpretation. Expert Rev Med Devices 2017;14:197-212.PubMedPubMedCentral
40.
go back to reference D’Agostino RB Sr, et al. General cardiovascular risk profile for use in primary care: The Framingham Heart Study. Circulation 2008;117:743-53.PubMed D’Agostino RB Sr, et al. General cardiovascular risk profile for use in primary care: The Framingham Heart Study. Circulation 2008;117:743-53.PubMed
41.
go back to reference Kannel WB, et al. An investigation of coronary heart disease in families. The Framingham offspring study. Am J Epidemiol 1979;110:281-90.PubMed Kannel WB, et al. An investigation of coronary heart disease in families. The Framingham offspring study. Am J Epidemiol 1979;110:281-90.PubMed
42.
go back to reference Dawber TR, Meadors GF, Moore FE Jr. Epidemiological approaches to heart disease: The Framingham Study. Am J Public Health Nations Health 1951;41:279-81.PubMedPubMedCentral Dawber TR, Meadors GF, Moore FE Jr. Epidemiological approaches to heart disease: The Framingham Study. Am J Public Health Nations Health 1951;41:279-81.PubMedPubMedCentral
43.
go back to reference D’Agostino RB Sr, et al. Validation of the Framingham coronary heart disease prediction scores: Results of a multiple ethnic groups investigation. JAMA 2001;286:180-7.PubMed D’Agostino RB Sr, et al. Validation of the Framingham coronary heart disease prediction scores: Results of a multiple ethnic groups investigation. JAMA 2001;286:180-7.PubMed
44.
go back to reference Hippisley-Cox J, et al. Derivation and validation of QRISK, a new cardiovascular disease risk score for the United Kingdom: Prospective open cohort study. BMJ 2007;335:136.PubMedPubMedCentral Hippisley-Cox J, et al. Derivation and validation of QRISK, a new cardiovascular disease risk score for the United Kingdom: Prospective open cohort study. BMJ 2007;335:136.PubMedPubMedCentral
45.
go back to reference Hippisley-Cox J, et al. Predicting cardiovascular risk in England and Wales: Prospective derivation and validation of QRISK2. BMJ 2008;336:1475-82.PubMedPubMedCentral Hippisley-Cox J, et al. Predicting cardiovascular risk in England and Wales: Prospective derivation and validation of QRISK2. BMJ 2008;336:1475-82.PubMedPubMedCentral
46.
go back to reference Hippisley-Cox J, Coupland C, Brindle P. Development and validation of QRISK3 risk prediction algorithms to estimate future risk of cardiovascular disease: Prospective cohort study. BMJ 2017;357:j2099.PubMedPubMedCentral Hippisley-Cox J, Coupland C, Brindle P. Development and validation of QRISK3 risk prediction algorithms to estimate future risk of cardiovascular disease: Prospective cohort study. BMJ 2017;357:j2099.PubMedPubMedCentral
47.
go back to reference Minhas JS, Patel P, Gupta PK. Limitations of a cardiac risk (QRISK2) calculator in patients with high density lipoprotein (HDL). High Blood Press Cardiovasc Prev 2016;23:47-50.PubMed Minhas JS, Patel P, Gupta PK. Limitations of a cardiac risk (QRISK2) calculator in patients with high density lipoprotein (HDL). High Blood Press Cardiovasc Prev 2016;23:47-50.PubMed
48.
go back to reference Collins GS, Altman DG. An independent external validation and evaluation of QRISK cardiovascular risk prediction: A prospective open cohort study. BMJ 2009;339:b2584.PubMedPubMedCentral Collins GS, Altman DG. An independent external validation and evaluation of QRISK cardiovascular risk prediction: A prospective open cohort study. BMJ 2009;339:b2584.PubMedPubMedCentral
49.
go back to reference Woodward M, et al. Adding social deprivation and family history to cardiovascular risk assessment: The ASSIGN score from the Scottish Heart Health Extended Cohort (SHHEC). Heart 2007;93:172-6.PubMed Woodward M, et al. Adding social deprivation and family history to cardiovascular risk assessment: The ASSIGN score from the Scottish Heart Health Extended Cohort (SHHEC). Heart 2007;93:172-6.PubMed
50.
go back to reference Conroy RM, et al. Estimation of ten-year risk of fatal cardiovascular disease in Europe: The SCORE project. Eur Heart J 2003;24:987-1003.PubMed Conroy RM, et al. Estimation of ten-year risk of fatal cardiovascular disease in Europe: The SCORE project. Eur Heart J 2003;24:987-1003.PubMed
51.
go back to reference Organization WH. Prevention of cardiovascular disease guidelines for assessment and management of cardiovascular risk. Genenva: WHO; 2007. Organization WH. Prevention of cardiovascular disease guidelines for assessment and management of cardiovascular risk. Genenva: WHO; 2007.
52.
go back to reference Otgontuya D, et al. Assessment of total cardiovascular risk using WHO/ISH risk prediction charts in three low and middle income countries in Asia. BMC Public Health 2013;13:539.PubMedPubMedCentral Otgontuya D, et al. Assessment of total cardiovascular risk using WHO/ISH risk prediction charts in three low and middle income countries in Asia. BMC Public Health 2013;13:539.PubMedPubMedCentral
53.
go back to reference Selvarajah S, et al. Comparison of the Framingham Risk Score, SCORE and WHO/ISH cardiovascular risk prediction models in an Asian population. Int J Cardiol 2014;176:211-8.PubMed Selvarajah S, et al. Comparison of the Framingham Risk Score, SCORE and WHO/ISH cardiovascular risk prediction models in an Asian population. Int J Cardiol 2014;176:211-8.PubMed
54.
go back to reference Stone NJ, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014;129:S1-45.PubMed Stone NJ, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014;129:S1-45.PubMed
55.
go back to reference Goff DC Jr, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task force on practice guidelines. Circulation 2014;129:S49-73.PubMed Goff DC Jr, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task force on practice guidelines. Circulation 2014;129:S49-73.PubMed
56.
go back to reference Board J. Joint British Societies’ consensus recommendations for the prevention of cardiovascular disease (JBS3). Heart 2014;100(Suppl 2):1-67. Board J. Joint British Societies’ consensus recommendations for the prevention of cardiovascular disease (JBS3). Heart 2014;100(Suppl 2):1-67.
Metadata
Title
Cardiovascular risk assessment models: Have we found the perfect solution yet?
Authors
Aiden Abidov, MD, PhD
Omar Chehab, MD, MSc
Publication date
01-12-2020
Publisher
Springer International Publishing
Published in
Journal of Nuclear Cardiology / Issue 6/2020
Print ISSN: 1071-3581
Electronic ISSN: 1532-6551
DOI
https://doi.org/10.1007/s12350-019-01642-x

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