Tag Archives: risk assessment

Why should lipoprotein(a) be measured? The cardiovascular risk conferred by serum lipoprotein(a) (Lp(a)) in large noteworthy epidemiological studies1,2 over two decades ago was inconsistent and often underestimated owing to poor standardisation of the commercially available Lp(a) immunoassays. During the last decade, however, genome-wide association and Mendelian randomisation studies have identified Lp(a) as a new risk factor for calcific aortic stenosis and as a causal risk factor for atherosclerotic cardiovascular disease (ASCVD) across ethnicities.3,4 Elevated Lp(a) is associated with accelerated progression of low-attenuation plaque for

Introduction For many years, the exercise tolerance test (ETT) has been the first-line investigation in patients presenting with stable chest pain. However, equivocal and false-positive results often lead to additional investigations. In recent years, computed tomography (CT) coronary angiography (CTCA) has been demonstrated to have excellent negative predictive value, making it a useful test to rule out obstructive coronary artery disease (CAD).1-3 In 2010, the UK National Institute for Health and Care Excellence (NICE) published clinical guideline 95: ‘Chest pain of recent onset’. This guideline advocates the use of a new risk estimatio

Introduction Cardiovascular disease (CVD) is a major cause of morbidity and mortality, particularly in deprived communities.1 Community or primary care based vascular risk assessment programmes are being introduced in England,2 Scotland and Wales, and are becoming central to USA health reform plans.3 However, the evidence base for these programmes is still emerging.4 The World Health Organization (WHO) estimate that better use of existing preventative measures could reduce the global burden of disease by as much as 70%5 based on some evidence from CVD prevention interventions that target risk factor management.6-8 However, the most effective