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Risk Factors Falter in Predicting Heart Issues

Classic risk factors, such as those in Framingham study, don't predict cardiovascular mortality in elderly

FRIDAY, Jan. 9 (HealthDay News) -- The use of traditional risk factors in predicting cardiovascular mortality or coronary atherosclerotic disease faces shortcomings, according to two studies published online Jan. 8 in BMJ and in the January issue of the American Journal of Roentgenology.

In the first study, Wouter de Ruijter, M.D., of the Leiden University Medical Center in Leiden, the Netherlands, and colleagues analyzed data from 302 participants aged 85 years with no history of cardiovascular disease. A variety of risk factors were assessed at baseline, and subjects were followed for five years. The investigators found that classic risk factors, such as those in the Framingham risk score, didn't predict cardiovascular mortality. However, a model using only homocysteine concentration could point out those at high risk of cardiovascular mortality, the researchers report.

In the second study, Kevin M. Johnson, M.D., of the Yale University School of Medicine in New Haven, Conn., and colleagues analyzed data from 1,653 people without a history of heart disease who underwent coronary CT angiography (CTA). The investigators found that the Framingham 10-year risk estimate correlated only modestly with atherosclerosis scores, and National Cholesterol Education Program (NCEP) core risk categories only had weak agreement with plaque categories.

"In conclusion, the Framingham and NCEP core risk categories do not reflect the amount of coronary atherosclerotic disease detected at coronary CTA in individual patients. Our study confirms the observations of others who used calcium scoring and extends the conclusion to include all plaque, calcified and uncalcified, detected at coronary CTA," Johnson and colleagues write.

Two co-authors of the second study disclosed relationships with several health care companies.

Abstract - de Ruijter
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Abstract - Johnson
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