Cardiovascular Risk Assessment: From Global Risk Scoring to Subclinical Atherosclerosis and the Role of Coronary Calcium

• Preventive cardiology efforts begin with assessment of CVD risk.

• Despite many available risk assessment approaches, a substantial gap remains in the detection of asymptomatic individuals who ultimately develop CHD.

• Most MIs are caused by low-grade stenoses.

• Criteria required for a good screening test

• Provides an accurate determination of the likelihood that an asymptomatic person has the condition.

• Reproducible results.

• Detect individuals where early intervention is likely to have a beneficial impact.

• Should provide incremental value to risk predicted by office-based assessment.

• Role for a complementary approach predicting ASCVD risk

• Global risk assessment with family history and other measures.

• Biomarkers (ideally predicting near-term risk).

• Subclinical disease imaging for atherosclerotic burden.