TUESDAY, Aug. 21 (HealthDay News) -- The addition of certain novel risk markers can improve risk prediction for incident coronary heart disease (CHD) or cardiovascular disease (CVD) above that of the Framingham Risk Score (FRS) in intermediate-risk individuals; while the addition of the carotid intima-media thickness (CIMT) offers limited improvement in risk prediction for first-time myocardial infarction or stroke, above that of the FRS, according to two studies published in the Aug. 22/29 issue of the Journal of the American Medical Association.
Joseph Yeboah, M.D., from the Wake Forest University School of Medicine in Winston-Salem, N.C. and colleagues examined whether the use of six risk markers (coronary artery calcium, CIMT, ankle-brachial index, brachial flow-mediated dilation, high-sensitivity C-reactive protein [CRP], and family history of CHD) improves prediction of incident CHD or CVD, above that of the FRS, in an intermediate-risk cohort involving 1,330 participants. After a median of 7.6 years of follow-up, the researchers found that coronary artery calcium, ankle-brachial index, high-sensitivity CRP, and family history were independently associated with CHD and CVD in multivariable analyses, with coronary artery calcium providing the best discrimination.
Hester M. Den Ruijter, Ph.D., from the University Medical Center Utrecht in the Netherlands, and colleagues reviewed data from 14 population-based cohorts, involving 45,828 individuals, to examine whether common CIMT improves 10-year risk prediction of first-time myocardial infarction or stroke, above that of the FRS. The researchers found that there was a small improvement in the net reclassification (0.8 percent), with an improvement of 3.6 percent for intermediate-risk individuals.
"The added value of common CIMT in 10-year risk prediction of cardiovascular events, in addition to the Framingham Risk Score, was small and unlikely to be of clinical importance," Den Ruijter and colleagues conclude.
Authors from both studies disclosed financial ties to the pharmaceutical and/or biomedical industries.
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