| Risk stratification in cardiovascular disease primary prevention - scoring systems, novel markers, and imaging techniques. | |
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MedLine Citation:
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PMID: 22220636 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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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. |
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Authors:
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Faiez Zannad; Guy De Backer; Ian Graham; Matthias Lorenz; Giuseppe Mancia; David A Morrow; Zeljko Reiner; Wolfgang Koenig; Jean Dallongeville; Robert J Macfadyen; Luis M Ruilope; Lars Wilhelmsen; |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-1-5 |
Journal Detail:
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Title: Fundamental & clinical pharmacology Volume: - ISSN: 1472-8206 ISO Abbreviation: - Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2012-1-6 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8710411 Medline TA: Fundam Clin Pharmacol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2012 The Authors Fundamental and Clinical Pharmacology © 2012 Société Française de Pharmacologie et de Thérapeutique. |
Affiliation:
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Centre for Clinical Investigation, Institut Lorrain du Coeur et des Vaisseaux, CHU Brabois, 54500 Vandoeuvre, France Department of Public Health, Ghent University, De Pintelaan 185, Gent B-9000, Belgium Department of Cardiology, Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland Department of Neurology, Frankfurt University, Frankfurt D-60528, Germany Division of Internal Medicine, University of Milan-Bicocca, Monza, Milan, Italy Division of Cardiovascular Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA University Hospital Center, School of Medicine, University of Zagreb, Salata 2, 10 000, Zagreb, Croatia Department of Internal Medicine II ? Cardiology, University of Ulm Medical School, Robert-Koch Str 8, D-89081, Ulm, Germany Department of Epidemiology and Public Health at Pasteur Institute of Lille, 1 rue du Pr. Calmette, BP 245, F-59019, Lille Cedex, France University Department of Medicine, City Hospital, NHS Trust, Dudley Road, Birmingham B18 7QH, UK Hypertension Unit, 12 de Octubre Hospital, Madrid 28041, Spain Department of Medicine, University of Gothenburg, SE-405 30, Gothenburg, Sweden. |
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