Using Nontraditional Risk Factors in Coronary Heart Disease Risk Assessment: US Preventive Services Task Force Recommendation Statement

被引：130

作者：

Calonge, Ned ^{[2
]}

Petitti, Diana B. ^{[3
]}

DeWitt, Thomas G. ^{[4
]}

Gregory, Kimberly D. ^{[5
]}

Harris, Russell ^{[6
]}

Isham, George ^{[7
]}

LeFevre, Michael L. ^{[8
]}

Loveland-Cherry, Carol ^{[9
]}

Marion, Lucy N. ^{[10
]}

Moyer, Virginia A. ^{[11
]}

Ockene, Judith K. ^{[12
]}

Sawaya, George F. ^{[13
]}

Siu, Albert L. ^{[14
]}

Teutsch, Steven M. ^{[15
]}

Yawn, Barbara P. ^{[16
]}

机构：

[1] US Prevent Serv Task Force, Agcy Healthcare Res & Qual, Rockville, MD USA

[2] Colorado Dept Publ Hlth & Environm, Denver, CO USA

[3] Arizona State Univ, Phoenix, AZ USA

[4] Childrens Hosp, Med Ctr, Cincinnati, OH 45229 USA

[5] Cedars Sinai Med Ctr, Los Angeles, CA 90048 USA

[6] Univ N Carolina, Sch Med, Chapel Hill, NC USA

[7] HealthPartners, Minneapolis, MN USA

[8] Univ Missouri, Sch Med, Columbia, MO USA

[9] Univ Michigan, Sch Nursing, Ann Arbor, MI 48109 USA

[10] Med Coll Georgia, Augusta, GA 30912 USA

[11] Baylor Coll Med, Houston, TX 77030 USA

[12] Univ Massachusetts, Sch Med, Worcester, MA USA

[13] Univ Calif San Francisco, San Francisco, CA 94143 USA

[14] Mt Sinai Med Ctr, New York, NY 10029 USA

[15] Merck & Co Inc, West Point, PA USA

[16] Olmsted Med Ctr, Rochester, MN USA

来源：

ANNALS OF INTERNAL MEDICINE | 2009年 / 151卷 / 07期

关键词：

BEAM COMPUTED-TOMOGRAPHY; C-REACTIVE PROTEIN; ARTERY CALCIUM SCORE; CARDIOVASCULAR-DISEASE; MYOCARDIAL-INFARCTION; ATHEROSCLEROSIS RISK; PRIMARY-CARE; EVENTS; PREDICTION; RATIONALE;

D O I：

10.7326/0003-4819-151-7-200910060-00008

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Description: New recommendation from the U.S. Preventive Services Task Force (USPSTF) on the use of nontraditional, or novel, risk factors in assessing the coronary heart disease (CHD) risk of asymptomatic persons. Methods: Systematic reviews were conducted of literature since 1996 on 9 proposed nontraditional markers of CHD risk: high-sensitivity C-reactive protein, ankle-brachial index, leukocyte count, fasting blood glucose, periodontal disease, carotid intima-media thickness, coronary artery calcification score on electron-beam computed tomography, homocysteine, and lipoprotein(a). The reviews followed a hierarchical approach aimed at determining which factors could practically and definitively reassign persons assessed as intermediate-risk according to their Framingham score to either a high-risk or low-risk strata, and thereby improve outcomes by means of aggressive risk-factor modification in those newly assigned to the high-risk stratum. Recommendation: The USPSTF concludes that the current evidence is insufficient to assess 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. (I statement).

引用

页码：474 / W160

页数：10

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