Evaluating cardiovascular risk assessment for asymptomatic people

Published 5 January 2009, doi:10.1136/bmj.a2844
Cite this as: BMJ 2009;338:a2844

Clinical Review

Ian A Scott, associate professor of medicine

¹ Department of Internal Medicine and Clinical Epidemiology, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia

Correspondence to: I A Scott ian_scott@health.qld.gov.au

The first 150 words of the full text of this article appear below.

Risk prediction tools based on the Framinghamscore are the most widely used for determining individuals’absolute risk based on clinical risk factors, although newertools are better calibrated
The clinical label metabolic syndromeand abnormalities on the resting electrocardiograph do not addprognostic information beyond that obtained by traditional riskfactors
Exercise stress electrocardiography that generatesa positive or negative result based on ST deviation alone isnot predictive, although scores that integrate several electrocardiographicand clinical variables may be predictive in patients at intermediaterisk
Laboratory biomarkers, even in the form of multimarkerpanels, are not helpful in refining clinical risk estimates
Imagingof subclinical atherosclerosis with computed coronary angiographycan identify patients at significantly increased risk, but onlya small proportion of patients screened fall into this group
Norandomised evidence to date has shown that informing cliniciansand patients of absolute risk of cardiovascular events leads. . . [Full text of this article]

Framingham riskscore⁹
QRISK¹¹
ASSIGN¹²

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