cardiac risk assessment
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Introduction
Assessment of risk for cardiac & cardiovascular disease.
Classification
- low risk < 5%
- intermediate risk defined as 5%-7.5%
- 7.5% - 10% high risk AAC/AHA, but not VAMC, USPSTF
- > 10% high risk
May include:
- lipid panel
- homocysteine in serum
- electrocardiogram
- cardiac stress testing
- echocardiogram
- computed tomography
- coronary artery calcium score better than polygenic risk score[7]
- coronary angiography
Combination of:
- cardiac-specific troponin-I
- serum N-terminal pro-BNP
- serum cystatin C (indicator of renal failure)
- high-sensitivity serum C-reactive protein
may predict risk of cardiovascular death in elderly men[2]
high-sensitivity serum C-reactive protein indicated for patients at intermediate risk[4][5]
Combination of serum apolipoprotein B, serum apolipoprotein A-1, serum lipoprotein<a> & serum lipoprotein-associated phospholipase A2 less useful than total cholesterol + HDL cholesterol at predicting cardiovascular risk; adding these markers to conventional risk factors improved risk prediction only slightly[3]
* measurements of nonfasting total & HDL cholesterol adequate[6]
Also see perioperative risk assessment
More general terms
More specific terms
Additional terms
- cardiac risk index (CRI)
- cardiovascular risk factor
- Framingham Risk Score/Calculator
- perioperative risk assessment
References
- ↑ Cardiac Risk Assessment Lab Tests Online: http://www.labtestsonline.org/understanding/analytes/cardiac_risk/glance.html
- ↑ 2.0 2.1 Zethelius B et al, Use of multiple biomarkers to improve the prediction of death from cardiovascular causes. New Engl J Med 2008, 358:2107 PMID: https://www.ncbi.nlm.nih.gov/pubmed/18480203
deLemos JA and Lloyd-Jones DM Multiple biomarker panesl for cardiovascular risk assessment. New Engl J Med 2008, 358:2172 PMID: https://www.ncbi.nlm.nih.gov/pubmed/18480211 - ↑ 3.0 3.1 The Emerging Risk Factors Collaboration. Lipid-related markers and cardiovascular disease prediction. JAMA 2012 Jun 20; 307:2499. PMID: https://www.ncbi.nlm.nih.gov/pubmed/2279745
- ↑ 4.0 4.1 Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015
- ↑ 5.0 5.1 Ridker PM, Danielson E, Fonseca FA Rosuvastatin to prevent vascular events in men and women with levated C-reactive protein. N Engl J Med. 2008 Nov 20;359(21):2195-207 PMID: https://www.ncbi.nlm.nih.gov/pubmed/18997196
- ↑ 6.0 6.1 Welsh C, Celis-Morales CA, Brown R et al. Comparison of conventional lipoprotein tests and apolipoproteins in the prediction of cardiovascular disease: Data from UK Biobank. Circulation 2019 Jun 20; PMID: https://www.ncbi.nlm.nih.gov/pubmed/31216866 https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.119.041149
- ↑ 7.0 7.1 Khan SS et al. Coronary artery calcium score and polygenic risk score for the prediction of coronary heart disease events. JAMA 2023 May 23; 329:1768. PMID: https://www.ncbi.nlm.nih.gov/pubmed/37219552 PMCID: PMC10208141 (available on 2023-11-23) https://jamanetwork.com/journals/jama/fullarticle/2805138