The Utility of Emerging Biomarkers and Imaging for Assessment of Cardiovascular Risk

The need of early, preclinical detection of disease is given by the fact that in 50% of patients dying due to coronary death, mortality is neither heralded by cardiac symptoms nor diagnosis make. The risk during life of suffering of consequences of atherosclerosis can be efficiently assessed through the Framingham risk score (among several other global risk scores). Global risk scores although originally formulated to give a numerical estimate of the risk, give generally a rough categorization of the patient into a low, (0-10%) intermediate (10%-20%) or high (>20%) risk. Furthermore the boarders between intermediate and low or high risk are frequently not uniform. Although global risk score evaluation are considered efficient tools in medical practice, over-or underestimation of risk has been reported in several studies. These are the mean reason why many investigators embarked during the last two decades in an effort to discover newer predictive markers. Among them few have passed the threshold of a rigorous assessment of their predictive power including analysis not only of statistical association but also of calibration, discrimination, and reclassification.