Whither Cardiovascular Disease Risk Prediction
Risk prediction models are common in the practice of preventive cardiology. Considerable effort has been devoted over the last 30 years to the discovery and validation of new risk markers, and this interest continues and is growing. Additionally, much research effort is devoted to assessing whether new risk markers provide useful clinical information beyond previously available risk models. Interest in the predictive utility of new risk markers extends well beyond preventive cardiology, but it has been a major focus within cardiology due to the availability of drug therapies that can be directed to patients at risk for cardiovascular events. Given the widespread exposure to risk factors in western societies, a large proportion of the population is potentially at risk for a cardiovascular event. Defining which individuals are proper candidates for drug treatments identifies the need for more accurate prediction models. Therefore, an efficient predictive model that properly categorizes the lowest risk people (who may then be able to avoid drug treatments) and the highest risk people (who would stand to benefit the most from drug treatments) should be of great value in the practice of cardiovascular disease prevention. In this Ancel Keys Memorial Lecture, new markers will be assessed for their utility to contribute to an efficient and improved risk assessment strategy. Newer statistical measures to assess risk markers will be discussed and evaluated for their ability to assist in defining the highest risk — and lowest risk — individuals within the general population. Whether any of the numerous available tests now have the capability of improving upon standard risk factors for prediction, and also improving clinical decision-making, will be major topics of this lecture.
- © 2010 by American Heart Association, Inc.