Why is Atherosclerotic Cardiovascular Disease Risk Overestimated by the ACC/AHA Pooled Cohort Equation?

The 2013 ACC/AHA Cholesterol Guidelines expand the recommendations for statin use to populations previously felt to be at lower risk. Central to risk-estimation in these guidelines is a new equation for determination of atherosclerotic cardiovascular disease (ASCVD) risk. However, this risk model has been criticized overestimating ASCVD risk in validation studies of the model.  Using […]

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Differences in Statin Eligible Patients across Guidelines

Recent ACC/AHA guidelines recommend consideration of statin therapy among patients with a 7.5% 10-year risk of atherosclerotic cardiovascular disease (CVD).  In this study, the authors examined implications of these new guidelines as compared with previous European Society of Cardiology (ESC) and Adult Treatment Panel III (ATP III) guidelines in a Dutch population-based prospective cohort of […]

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Validation of the Pooled Cohort Risk Equations from Recent ACC/AHA Guidelines

Recent American College of Cardiology/American Heart Association (ACC/AHA) guidelines for the assessment of cardiovascular risk recommend a new 10-year atherosclerotic cardiovascular disease (CVD) risk prediction tool called the Pooled Cohort risk equation. This new predictive model developed from cohorts of patients that were largely studied prior to the year 2000.  In light of the declining […]

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Glycemic measurements are not helpful in CVD risk prediction among non-diabetics

Several clinical guidelines recommend measurement of glycated hemoglobin (HbA1c) to guide cardiovascular risk (CVD) risk assessment. In this study, the authors examined the utility of adding HbA1c measurements to conventional risk factors in prediction of CVD among non-diabetic patients. Data from 73 prospective studies with nearly 300,000 non-diabetic patients without known CVD at enrollment was […]

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Coronary artery calcium density is inversely associated with coronary risk

  Coronary calcium is associated with cardiovascular disease risk.  However, it may not only be the volume, but the density of coronary calcium that influences risk as more dense calcium may reflect stable plaque at lower risk of inciting coronary events.  The traditional Agatson method of scoring coronary calcium burden does not consider coronary calcium […]

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Testosterone replacement associated with higher risk for adverse cardiovascular events

Despite limited data on cardiovascular safety, rates of testosterone therapy are increasing dramatically. In a retrospective cohort study of 8,709 male Veterans with a low testosterone level, the authors sought to determine the association between use of testosterone therapy following coronary angiography and patient outcomes of all-cause mortality, myocardial infarction and stroke. […]

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Influenza vaccine protects against adverse cardiovascular events

Evidence supporting the use of influenza vaccine in patients at risk for coronary artery events largely comes from observational studies or small randomized trials (RCTs). In this study, the authors conducted a systematic review of 6 RCTs (5 published, 1 unpublished) comparing influenza vaccine to placebo on the rate of a composite of major adverse […]

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A Randomized Trial of the “Polypill” for Cardiovascular Risk Modification

Long-term use of recommended cardiovascular (CV) risk modifying medications is low among patients at high-risk for CV events.  Fixed-dose drug combination (FDC) therapy may reduce treatment gaps by lowering non-adherence, cost, complexity and therapeutic inertia. However, FDC may also reduce tailoring of individual medications and thereby lead to suboptimal risk control. The UMPIRE (Use of […]

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Lipid-related markers improve cardiovascular disease prediction

While the measurement and management of cholesterol forms an integral part of cardiovascular risk management, it has been suggested that risk assessment could be improved by the assessment of various additional lipid-related markers either to supplement or replace traditional cholesterol measurements.  The aim of this paper was to determine whether cardiovascular risk prediction could be […]

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Coronary Artery Calcium Scanning Improves Risk Stratification

In the JUPITER study, patients with low cholesterol levels but raised high-sensitivity C-reactive protein (hsCRP) levels were seen to benefit from treatment with rosuvastatin, although overall cardiovascular events were low.  In this study, the authors investigated whether the use of coronary artery calcium (CAC) scoring could further stratify risk in a population of patients from […]

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