Assessing coronary heart disease risk with traditional and novel risk factors


  • Peter W. F. Wilson M.D.

    Corresponding author
    1. Department of Endocrinology, Diabetes, and Medical Geriatrics, Medical University of South Carolina, Charleston, South Carolina, USA
    • Dept. of Endocrinology, Diabetes, and Medical Genetics Medical University of South Carolina 96 Jonathan Lucas St, Suite 215 P.O. Box 250609 Charleston, SC 29425, USA===

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Cardiovascular disease is the leading cause of death in the industrialized world, and a number of well-characterized factors, including advanced age, hypertension, dyslipidemia, diabetes, and smoking, contribute to cardiovascular risk. Integration of these factors using the Framingham calculation estimates the absolute 10-year risk for coronary heart disease (CHD), which can be used to guide therapy. Recent studies have demonstrated that additional markers, including elevated lipoprotein(a), homocysteine, sitosterol, and particularly C-reactive protein (CRP), are also associated with increased risk for CHD. In particular, high-sensitivity CRP has been shown to identify patients with high CHD risk who may not have elevated low-density lipoprotein cholesterol (LDL-C) and may add to the predictive value of the Framing-ham functions for CHD risk assessment. Assessment of global risk is particularly important in lipid management, as the LDL-C target goals are determined by risk category.