Novel Risk Factors Not Found Useful for Heart Screening


U.S. Preventive Services Task Force says evidence for nine proposed risk factors is insufficient

11 oct 2009-- After a systematic review of the research, the U.S. Preventive Services Task Force (USPSTF) finds there is insufficient evidence to support the use of any of nine novel risk factors in the routine screening of patients for coronary heart disease (CHD), according to a study in the Oct. 6 Annals of Internal Medicine.

The U.S. Preventive Services Task Force, from the Agency for Healthcare Research and Quality in Rockville, Md., reviewed the research since 1996 on the nine potential CHD risk factors, including C-reactive protein, lipoprotein(a), coronary artery calcium, leukocyte count, fasting blood glucose, homocysteine, periodontal disease, ankle-brachial index and carotid intima-media thickness. The reviewers evaluated each factor for reclassifying a patient at intermediate-risk for CHD (based on established risk factors) to a low-risk or high-risk status. While C-reactive protein was found to have some predictive value, the task force found insufficient evidence to support reclassification using any of the risk factors.

In a related study conducted for the USPSTF published in the same journal, Mark Helfand, M.D., of the Oregon Evidence-based Practice Center, and colleagues evaluated the same risk factors. The researchers conclude that C-reactive protein was both the most studied and most likely candidate for patient screening, but the evidence was inconclusive.

"The USPSTF concludes that the current evidence is insufficient to asses the balance of benefits and harms of using the nontraditional risk factors studied to screen asymptomatic men and women with no history of CHD to prevent CHD events," authors of the first study write.

Abstract - USPSTF
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