title: Between risk charts and imaging: how should we stratify cardiovascular risk in clinical practice?
abstract: Cardiovascular (CV) risk prediction has a central role in primary CV prevention. Several risk charts have been developed in the attempt to identify subjects at risk who might benefit from more aggressive interventions. However, risk charts show main limitations and they remain underutilized in general practice. The addition of novel risk markers has substantially failed to improve risk charts discrimination power. Imaging has recently gained relevance in CV risk stratification for its ability to detect subclinical atherosclerosis. Although extending non-invasive imaging to all asymptomatic middle-aged people is currently not recommended, its progressive spread may provide information on preclinical atherosclerosis and detection of de facto initial disease might overcome some limitations of conventional risk stratification charts.
authors.affiliation: Cardiovascular Secondary Prevention and Echocardiography Unit, Department of Cardiovascular Diseases, S. Giovanni-Addolorata Hospital, Via Amba Aradam, 8, 00184 Rome, Italy. gfmureddu@tiscali.it
authors.forename: Gian Francesco
authors.initials: GF
authors.lastname: Mureddu
authors.forename: Filippo
authors.initials: F
authors.lastname: Brandimarte
authors.forename: Pompilio
authors.initials: P
authors.lastname: Faggiano
authors.forename: Fausto
authors.initials: F
authors.lastname: Rigo
authors.forename: Uwe
authors.initials: U
authors.lastname: Nixdorff
mesh_terms: D002309:Cardiology / Q000458:organization & administration; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000517:prevention & control; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000517:prevention & control*; D003952:Diagnostic Imaging / Q000379:methods*; D042241:Early Diagnosis; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data*; D008875:Middle Aged; D011237:Predictive Value of Tests; D011322:Primary Prevention / Q000379:methods*; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed / Q000379:methods