Risk stratification in cardiovascular disease primary prevention - scoring systems, novel markers, and imaging techniques.

Hdl Handle:
http://hdl.handle.net/10147/253509
Title:
Risk stratification in cardiovascular disease primary prevention - scoring systems, novel markers, and imaging techniques.
Authors:
Zannad, Faiez; De Backer, Guy; Graham, Ian; Lorenz, Matthias; Mancia, Giuseppe; Morrow, David A; Reiner, Zeljko; Koenig, Wolfgang; Dallongeville, Jean; Macfadyen, Robert J; Ruilope, Luis M; Wilhelmsen, Lars
Affiliation:
Centre for Clinical Investigation, Institut Lorrain du Coeur et des Vaisseaux, CHU Brabois, 54500 Vandoeuvre, France. f.zannad@chu-nancy.fr
Citation:
Risk stratification in cardiovascular disease primary prevention - scoring systems, novel markers, and imaging techniques. 2012, 26 (2):163-74 Fundam Clin Pharmacol
Publisher:
Fundamental & clinical pharmacology
Journal:
Fundamental & clinical pharmacology
Issue Date:
Apr-2012
URI:
http://hdl.handle.net/10147/253509
DOI:
10.1111/j.1472-8206.2011.01023.x
PubMed ID:
22220636
Abstract:
The aim of this paper is to review and discuss current methods of risk stratification for cardiovascular disease (CVD) prevention, emerging biomarkers, and imaging techniques, and their relative merits and limitations. This report is based on discussions that took place among experts in the area during a special CardioVascular Clinical Trialists workshop organized by the European Society of Cardiology Working Group on Cardiovascular Pharmacology and Drug Therapy in September 2009. Classical risk factors such as blood pressure and low-density lipoprotein cholesterol levels remain the cornerstone of risk estimation in primary prevention but their use as a guide to management is limited by several factors: (i) thresholds for drug treatment vary with the available evidence for cost-effectiveness and benefit-to-risk ratios; (ii) assessment may be imprecise; (iii) residual risk may remain, even with effective control of dyslipidemia and hypertension. Novel measures include C-reactive protein, lipoprotein-associated phospholipase A(2) , genetic markers, and markers of subclinical organ damage, for which there are varying levels of evidence. High-resolution ultrasound and magnetic resonance imaging to assess carotid atherosclerotic lesions have potential but require further validation, standardization, and proof of clinical usefulness in the general population. In conclusion, classical risk scoring systems are available and inexpensive but have a number of limitations. Novel risk markers and imaging techniques may have a place in drug development and clinical trial design. However, their additional value above and beyond classical risk factors has yet to be determined for risk-guided therapy in CVD prevention.
Item Type:
Article
Language:
en
MeSH:
Biological Markers; Cardiovascular Diseases; Clinical Trials as Topic; Diagnostic Imaging; Drug Design; Humans; Primary Prevention; Research Design; Risk Assessment
ISSN:
1472-8206

Full metadata record

DC FieldValue Language
dc.contributor.authorZannad, Faiezen_GB
dc.contributor.authorDe Backer, Guyen_GB
dc.contributor.authorGraham, Ianen_GB
dc.contributor.authorLorenz, Matthiasen_GB
dc.contributor.authorMancia, Giuseppeen_GB
dc.contributor.authorMorrow, David Aen_GB
dc.contributor.authorReiner, Zeljkoen_GB
dc.contributor.authorKoenig, Wolfgangen_GB
dc.contributor.authorDallongeville, Jeanen_GB
dc.contributor.authorMacfadyen, Robert Jen_GB
dc.contributor.authorRuilope, Luis Men_GB
dc.contributor.authorWilhelmsen, Larsen_GB
dc.date.accessioned2012-11-27T16:24:52Z-
dc.date.available2012-11-27T16:24:52Z-
dc.date.issued2012-04-
dc.identifier.citationRisk stratification in cardiovascular disease primary prevention - scoring systems, novel markers, and imaging techniques. 2012, 26 (2):163-74 Fundam Clin Pharmacolen_GB
dc.identifier.issn1472-8206-
dc.identifier.pmid22220636-
dc.identifier.doi10.1111/j.1472-8206.2011.01023.x-
dc.identifier.urihttp://hdl.handle.net/10147/253509-
dc.description.abstractThe aim of this paper is to review and discuss current methods of risk stratification for cardiovascular disease (CVD) prevention, emerging biomarkers, and imaging techniques, and their relative merits and limitations. This report is based on discussions that took place among experts in the area during a special CardioVascular Clinical Trialists workshop organized by the European Society of Cardiology Working Group on Cardiovascular Pharmacology and Drug Therapy in September 2009. Classical risk factors such as blood pressure and low-density lipoprotein cholesterol levels remain the cornerstone of risk estimation in primary prevention but their use as a guide to management is limited by several factors: (i) thresholds for drug treatment vary with the available evidence for cost-effectiveness and benefit-to-risk ratios; (ii) assessment may be imprecise; (iii) residual risk may remain, even with effective control of dyslipidemia and hypertension. Novel measures include C-reactive protein, lipoprotein-associated phospholipase A(2) , genetic markers, and markers of subclinical organ damage, for which there are varying levels of evidence. High-resolution ultrasound and magnetic resonance imaging to assess carotid atherosclerotic lesions have potential but require further validation, standardization, and proof of clinical usefulness in the general population. In conclusion, classical risk scoring systems are available and inexpensive but have a number of limitations. Novel risk markers and imaging techniques may have a place in drug development and clinical trial design. However, their additional value above and beyond classical risk factors has yet to be determined for risk-guided therapy in CVD prevention.en_GB
dc.language.isoenen
dc.publisherFundamental & clinical pharmacologyen_GB
dc.rightsArchived with thanks to Fundamental & clinical pharmacologyen_GB
dc.subject.meshBiological Markers-
dc.subject.meshCardiovascular Diseases-
dc.subject.meshClinical Trials as Topic-
dc.subject.meshDiagnostic Imaging-
dc.subject.meshDrug Design-
dc.subject.meshHumans-
dc.subject.meshPrimary Prevention-
dc.subject.meshResearch Design-
dc.subject.meshRisk Assessment-
dc.titleRisk stratification in cardiovascular disease primary prevention - scoring systems, novel markers, and imaging techniques.en_GB
dc.typeArticleen
dc.contributor.departmentCentre for Clinical Investigation, Institut Lorrain du Coeur et des Vaisseaux, CHU Brabois, 54500 Vandoeuvre, France. f.zannad@chu-nancy.fren_GB
dc.identifier.journalFundamental & clinical pharmacologyen_GB
dc.description.provinceLeinsteren

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