USPSTF ponders addition of new heart risk factors

The U.S. Preventive Services Task Force (USPSTF) has drafted a research plan for assessing cardiovascular disease risk, and it is accepting public comments on the idea of adding nontraditional measures such as coronary artery calcium into standard cardiovascular risk factor assessment for asymptomatic individuals.

USPSTF would like to determine whether incorporating three risk factors -- beyond the traditional two currently used, the Pooled Cohort Equations tool and the Framingham risk model -- could potentially improve health outcomes. To that end, the task force is looking for research on incorporating ankle-brachial index (ABI), coronary artery calcium (CAC), and high-sensitivity C-reactive protein (CRP) into the standard cardiovascular risk assessment.

In its public comments, USPSTF is asking for information on five questions:

• Compared with the Pooled Cohort Equations tool or Framingham risk factors alone, does risk assessment of asymptomatic adults using nontraditional risk factors lead to reduced incidence of cardiovascular events and/or mortality?
• Does the use of nontraditional risk factors in addition to traditional risk factors to predict cardiovascular disease risk improve measures of calibration, discrimination, and risk reclassification?
• What are the harms of nontraditional risk factor assessment?
• Does treatment guided by nontraditional risk factors in addition to traditional risk factors lead to reduced incidence of cardiovascular events and/or mortality?
• What are the harms of aggressive risk factor modification?

Respondents have until 8 p.m. EST on July 8 to comment on the proposed research plan.