PMID- 19805772
OWN - NLM
STAT- MEDLINE
DCOM- 20091021
LR  - 20190619
IS  - 1539-3704 (Electronic)
IS  - 0003-4819 (Linking)
VI  - 151
IP  - 7
DP  - 2009 Oct 6
TI  - Emerging risk factors for coronary heart disease: a summary of systematic reviews 
      conducted for the U.S. Preventive Services Task Force.
PG  - 496-507
AB  - BACKGROUND: Traditional risk factors do not explain all of the risk for incident 
      coronary heart disease (CHD) events. Various new or emerging risk factors have 
      the potential to improve global risk assessment for CHD. PURPOSE: To summarize 
      the results of 9 systematic reviews of novel risk factors to help the U.S. 
      Preventive Services Task Force (USPSTF) evaluate the factors' clinical 
      usefulness. DATA SOURCES: Results from a MEDLINE search for English-language 
      articles published from 1966 to September 2008, using the Medical Subject Heading 
      terms cohort studies and cardiovascular diseases in combination with terms for 
      each risk factor. STUDY SELECTION: Studies were included if the participants had 
      no baseline cardiovascular disease and the investigators adjusted for at least 6 
      Framingham risk factors. DATA EXTRACTION: Study quality was evaluated by using 
      USPSTF criteria and overall quality of evidence for each risk factor by using a 
      modified version of the Grading of Recommendations, Assessment, Development, and 
      Evaluation framework. Each factor's potential clinical value was evaluated by 
      using a set of criteria that emphasized the importance of the effect of that 
      factor on the reclassification of intermediate-risk persons. DATA SYNTHESIS: 9 
      systematic reviews were conducted. C-reactive protein (CRP) was the best 
      candidate for use in screening and the most rigorously studied, but evidence that 
      changes in CRP level lead to primary prevention of CHD events is inconclusive. 
      The other evaluated risk factors were coronary artery calcium score as measured 
      by electron-beam computed tomography, lipoprotein(a) level, homocysteine level, 
      leukocyte count, fasting blood glucose, periodontal disease, ankle-brachial 
      index, and carotid intima-media thickness. The availability and validity of the 
      evidence varied considerably across the risk factors in terms of aggregate 
      quality, consistency of findings, and applicability to intermediate-risk persons 
      in the general population. For most risk factors, no studies assessed their 
      usefulness for reclassifying intermediate-risk persons. LIMITATIONS: Because of 
      lack of access to original data, no firm conclusions could be drawn about 
      differences in risk prediction among racial and ethnic groups. The review did not 
      emphasize within-cohort comparisons of multiple risk factors. CONCLUSION: The 
      current evidence does not support the routine use of any of the 9 risk factors 
      for further risk stratification of intermediate-risk persons.
FAU - Helfand, Mark
AU  - Helfand M
AD  - Oregon Evidence-based Practice Center, Veterans Affairs Medical Center, andOregon 
      Health & Science University, Portland, Oregon 97239, USA.
FAU - Buckley, David I
AU  - Buckley DI
FAU - Freeman, Michele
AU  - Freeman M
FAU - Fu, Rongwei
AU  - Fu R
FAU - Rogers, Kevin
AU  - Rogers K
FAU - Fleming, Craig
AU  - Fleming C
FAU - Humphrey, Linda L
AU  - Humphrey LL
LA  - eng
GR  - 290-02-0024/PHS HHS/United States
PT  - Journal Article
PT  - Research Support, U.S. Gov't, P.H.S.
PT  - Review
PL  - United States
TA  - Ann Intern Med
JT  - Annals of internal medicine
JID - 0372351
RN  - 0 (Biomarkers)
SB  - IM
SPIN- Ann Intern Med. 2009 Oct 6;151(7):I-38. PMID: 19805766
MH  - Ankle Brachial Index
MH  - Biomarkers/blood
MH  - Calcinosis/diagnostic imaging
MH  - Carotid Artery Diseases/complications
MH  - Coronary Disease/*diagnosis/*prevention & control
MH  - Coronary Vessels/pathology
MH  - Humans
MH  - Periodontal Diseases/complications
MH  - Radiography
MH  - Risk Assessment
MH  - Risk Factors
RF  - 212
EDAT- 2009/10/07 06:00
MHDA- 2009/10/22 06:00
CRDT- 2009/10/07 06:00
PHST- 2009/10/07 06:00 [entrez]
PHST- 2009/10/07 06:00 [pubmed]
PHST- 2009/10/22 06:00 [medline]
AID - 151/7/496 [pii]
AID - 10.7326/0003-4819-151-7-200910060-00010 [doi]
PST - ppublish
SO  - Ann Intern Med. 2009 Oct 6;151(7):496-507. doi: 
      10.7326/0003-4819-151-7-200910060-00010.