January 7, 2009 - According to a study performed at the Yale University School of Medicine in New Haven, CT, the Framingham and National Cholesterol Education Program tools (NCEP) are not accurate predictors of coronary heart disease.
The study that included 1,653 patients with no history of coronary heart disease was published in the January issue of the American Journal of Roentgenology.
The 1,653 patients, including 738 currently taking statins, each had a coronary CT angiogram. Afterward, doctors compared the patients' risk of coronary heart disease, determined by the Framingham and NCEP risk assessment tools, to the amount of plaque actually found in their arteries as revealed by the scans.
According to the study's lead author, Kevin M. Johnson, M.D., "Twenty-six percent of the patients who were already taking statins (because of the risk factor assessment tools) had no detectable plaque at all.
"Risk assessment tools are used by physicians implicitly. Physicians use them as a way to separate and treat patients accordingly. Ultimately, the Framingham influences what every physician does, but I feel it is not good enough to show what is happening with each individual patient," said Dr. Johnson.
"The average person tends to put a lot of weight on family history, but the association between that and coronary heart disease is only modest," said Dr. Johnson. "We are living in an era where genetic research is in the headlines, but reality is a lot more complicated than that," he said.
"There are still 400,000 people a year who die from heart attacks and have no warning signs at all; doctors want to be able to find those people before that happens and I hope this study gets people interested in finding out better predictors for coronary heart disease," said Dr. Johnson.
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