Which risk markers are used in coronary artery atherosclerosis screening?

Updated: Apr 09, 2021
  • Author: Sandy N Shah, DO, MBA, FACC, FACP, FACOI; Chief Editor: Yasmine S Ali, MD, MSCI, FACC, FACP  more...
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A screening strategy for calculating cardiovascular risk that uses multiple non–laboratory-based risk markers performed as well as approaches based on Framingham risk scores, which use cholesterol measurements in all patients. The analysis was conducted using data on 5998 adults in the National Health and Nutrition Examination Survey (NHANES) III. The risk markers included age, sex, smoking status, history of diabetes, blood-pressure treatment, systolic blood pressure, and body mass index. [26, 27]

With the multistage-screening approach, patients deemed high risk would be treated with statins, those deemed low risk would be monitored without treatment, and intermediate-risk patients would undergo laboratory testing of cholesterol levels. There was no significant difference between the multistage approach and the Framingham risk score approach in discriminating risk. [26, 27]

The multistage screening strategy was also more cost effective than the Framingham approach. The incremental cost-effective ratio was $52,000 per quality-adjusted life-year (QALY) for men and $83,000 per QALY for women, compared with more than $300,000 per QALY with the Framingham approach. [26, 27]

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