Authors' objectives: BACKGROUND Cardio-vascular diseases (CVD) remain the most frequent cause of mortality in our population. Risk prediction models, such as the SCORE (Systematic COronary Risk Evaluation), allow the stratification of individuals in risk categories and to adapt the preventive management accordingly. The accuracy of SCORE could be improved by incorporating markers of subclinical atherosclerosis, particularly in individuals classified at intermediate risk

Authors' results and conclusions: RESULTS Coronary artery calcium score provided the highest incremental predictive value, with a net reclassification index ranging from 22% to 66% in individuals classified at intermediate risk. The added value of the ankle-brachial index, aortic pulse wave velocity and carotid plaque in risk reclassification was lower than for coronary calcium, at around 15%. The clinical benefit of integrating these 4 markers to SCORE was not formally assessed in studies. Economic evaluations were only identified for one marker: coronary artery calcium. The studies showed highly unstable results, sensitive to a number of assumptions, and in particularly to those relating to the price and efficacy of preventive treatments. CONCLUSION In the absence of high quality studies on the clinical effectiveness of measuring atherosclerosis markers beyond the traditional cardiovascular risk markers, and the consequent uncertainty surrounding their cost effectiveness, the utilization of these markers is not recommended. Improving the predictive value of SCORE by the addition of easy to collect information in first-line consultation (e.g. BMI, sedentarity) is a priority

Authors' methods: METHODS A rapid literature review was performed on the predictive increments (net reclassification index), clinical effectiveness and cost-effectiveness of non-invasive markers of subclinical atherosclerosis in asymptomatic individuals.

Project Status: Completed

Year Published: 2015

URL for published report: https://doi.org/10.57598/R244C

URL for additional information: https://kce.fgov.be/publication/report/non-invasive-markers-of-subclinical-atherosclerosis-for-predicting-a-primary-card

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Belgium

DOI: 10.57598/R244C

Organisation Name: Belgian Health Care Knowledge Centre

Contact Address: Administrative Centre Botanique, Doorbuilding (10th floor), Boulevard du Jardin Botanique 55, B-1000 Brussels, Belgium tel: +32 2 287 33 88 fax: +32 2 287 33 85

Contact Name: info@kce.fgov.be

Contact Email: info@kce.fgov.be

Copyright: <p>Belgian Health Care Knowledge Centre (KCE)</p>