Predictive ability of coronary artery calcium and CRP.

摘要

In the general population, less than 10% of healthy adults aged 25-74 years have no modifiable cardiovascular risk factors;1 therefore, risk of cardiovascular disease can potentially be improved in most people. Statin therapy for lowering cholesterol is an important cornerstone of risk reduction. The absolute benefit of statin treatment increases with increasing patient risk; thus, risk stratification of asymptomatic patients is mandatory in clinical practice. Although accurate identification of future cardiovascular disease risk is difficult when overall risk is low, the Framingham risk score and other global risk scores offer a meaningful approximation.2 Such algorithms now allow for a practical approach towards risk stratification, translating statistical data into quantification of an individual's global risk. However, many uncertainties remain: because more than 40% of individuals have an intermediate risk of 10-20% in 10 years, treatment options are restricted; the scores are best at predicting long-term risk even though substantial risk factor changes can occur over time; and levels of absolute risk differ across cultural and ethnic groups. Thus, individual risk stratification needs further improvement in asymptomatic adults.