Short and lifetime cardiovascular risk estimates: Same wine, different bottles. Do we have the COURAGE to abandon risk scores?

Excerpt

Cardiovascular disease (CVD) is the leading cause of mortality worldwide with coronary heart disease disease (CHD) accounting for nearly half of all CVD deaths.1 Because half of first major coronary events occur in asymptomatic individuals, clinicians who want to implement appropriate primary prevention therapy must be able to accurately identify “at risk” individuals. Currently major CVD risk stratification based strategies such as the Framingham risk score (FRS) as well and the recent 2013 ACC/AHA CVD risk score form the cornerstone of CVD risk assessment and guide the intensity of preventive strategies based on estimates of 10-year risk.1,2 However, extensive literature has clearly documented the uncertainty of these short-term predictive models and the predilection to miss a large portion of those truly at risk, especially younger individuals and women.3-6 …