New Study Questions Accuracy of Heart Disease Risk Assessment Tools

The American Roentgen Ray Society reported that two tools commonly used to assess patients for risk of CHD may not accurately predict patients’ risk of CHD.

The American Roentgen Ray Society (ARRS) recently reported that two tools commonly used to assess patients for risk of coronary heart disease (CHD) may not accurately predict patients’ risk of CHD.

According to an ARRS news release, a study performed at the Yale University School of Medicine revealed that the Framingham Risk Assessment and the National Cholesterol Education Program (NCEP) tools did not accurately predict CHD.

Researchers studied 1,653 patients with no history of coronary heart disease, 738 of whom were nevertheless taking statins because prior Framingham and NCEP assessment had identified increased risk of developing coronary heart disease. All study participants underwent a coronary CT angiogram and investigators compared their risk of coronary heart disease, determined by the Framingham and NCEP risk assessment tools, to the amount of plaque actually found in their arteries as a result of the scan.

Analysis of the angiograms revealed that 21% of the patients who were thought to need statin drugs before the scan did not require them, whereas 26% of the patients who were already taking statins had no detectable plaque at all.

“Risk assessment tools are used by physicians implicitly. Physicians use them as a way to separate and treat patients accordingly. Ultimately, the Framingham influences what every physician does, but I feel it is not good enough to show what is happening with each individual patient,” said Kevin M. Johnson, MD, lead author of the study.

Johnson also said, “The average person tends to put a lot of weight on family history, but the association between that and coronary heart disease is only modest. We are living in an era where genetic research is in the headlines, but reality is a lot more complicated than that.”

An abstract of the original study published in the January issue of the American Journal of Roentgenology is available here.

Additional Resources:

Risk Assessment Tool for Estimating 10-year Risk of Developing Hard CHD (Myocardial Infarction and Coronary Death)

National Cholesterol Education Program

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