An Assessment of Incremental Coronary Risk Prediction Using C-Reactive Protein and Other Novel Risk Markers

Abstract

Epidemiologic research has identified many risk factors associated with increased incidence of coronary heart disease (CHD). The Framingham Heart Study pioneered the use of the major risk factors (eg, age, high blood pressure, cigarette smoking, elevated total cholesterol level, low high-density lipoprotein cholesterol [HDL-C] level, and diabetes mellitus) in regression models to predict an individual's risk of CHD reasonably well.¹ The Framingham CHD prediction equations apply generally to other US populations,² including the middle-aged Atherosclerosis Risk in Communities (ARIC) Study cohort.³ Clinical professionals have adapted prediction models for use in preventive cardiology; for example, via the National Cholesterol Education Panel's adult treatment guidelines.⁴ An advantage of current prediction models is that most of the major risk factors included are modifiable, with known clinical benefit to their modification.