Individual Coronary Heart Disease Risk Prediction as Part of Primary Prevention

Correction of traditional risk factors (RF) at the population level resulted in considerable progress in prevention of coronary heart disease (CHD) in many countries. At the same time existing approaches to individual prediction of cardiovascular diseases based on the analysis of traditional RF and global risk scoring are in some cases ineffective. This problem most notably relates to a large group of persons with low calculated risk (young patients, persons without multiple RF, women) which accounts for the greatest in absolute numbers quantity of primary cardiovascular events. Attempts of improvement of individual CHD prediction deal with 1) discovering of new RF and their introduction in global scoring models, 2) cardiovascular imaging modalities which facilitate diagnosis of subclinical atherosclerosis, first of all an ultrasonic study of carotids and multi-detector computed tomography of coronary arteries. This review considers the prognostic value of most important standard global risk scoring models, the added value of new RF and role of data received from atherosclerosis imaging.