The brand new AHA/ACC 2013 cardiovascular risk calculator: is it applicable to a low-risk southern European population?

Size: px
Start display at page:

Download "The brand new AHA/ACC 2013 cardiovascular risk calculator: is it applicable to a low-risk southern European population?"

Transcription

1 XXXV Congresso Português de Cardiologia The brand new AHA/ACC 2013 cardiovascular risk calculator: is it applicable to a low-risk southern European population? Manuel Oliveira-Santos, Rui Baptista, Marta Rebelo, Diana Oliveira, Patrícia Dias, Rui Martins, José Pereira de Moura, Mariano Pêgo Serviço de Cardiologia A Serviço de Medicina Interna A

2 Background The brand new AHA/ACC risk calculator estimates atherosclerotic cardiovascular disease (ASCVD) risk at ten years: nonfatal myocardial infarction, CHD death, fatal or nonfatal stroke variables: age, total and HDL-cholesterol, systolic blood pressure (including treated or untreated status), diabetes and current smoking status Goff DC et al., 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk. Journal of the American College of Cardiology Europe: Systematic COronary Risk Evaluation (SCORE) system estimates the individual risk of fatal non-coronary atherosclerotic and coronary heart disease (CHD) variables: age, gender, lipids, blood pressure, and smoking Conroy RM et al., Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J Perk J et al., European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). Eur Heart J Catapano AL et al., ESC/EAS Guidelines for the management of dyslipidaemias. Atherosclerosis. 2011

3 Background (II) ASCVD risk 7.5% (40-75 ys + LDL mg/dL): indication for statin 5-7.5% -therapy? Stone NJ et al., 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults. Journal of the American College of Cardiology The ASCVD calculator has been criticised for risk overestimation, potentially leading to undue prescription Ridker PM et al., Statins: new American guidelines for prevention of cardiovascular disease. Lancet. 2013

4 Objective To investigate whether the ASCVD calculator overestimates cardiovascular (CV) risk in a Mediterranean cohort of patients, comparing it with the Systematic COronary Risk Evaluation (SCORE) stratification system from the European Society of Cardiology

5 Population and Methods Lipidology Clinic Centro Hospitalar e Universitário de Coimbra Inclusion: CV naïve patients Ten year Follow-up Acute myocardial infarction; Stroke; CV death Yusuf, S et al., The Heart Outcomes Prevention Evaluation Study Investigators. N Engl J Med Baseline SCORE system (low risk countries) and ASCVD risks calculation Four risk groups: <1% 1 to <5% 5 to <10% 10% <5% 5 to <7.5% 7.5 to <10% 10% compare the median expected event rate with the observed rate

6 Results Nº 446 Age (years) 48.9 ± 14.4 Male (%) 58.3 Systolic blood pressure (mmhg) Diastolic blood pressure (mmhg) Antihypertensive drug treatment (%) ± ± Type 2 diabetes (%) 24.8 Body mass index (kg/m 2 ) 28.1 ± years (85% follow-up) Total cholesterol (mg/dl) ± 77.6 High density lipoprotein-cholesterol (mg/dl) Low density lipoprotein-cholesterol (mg/dl) Statin treatment (%) ± ± 66.7 Creatinine (mg/dl) 0.96 ± 0.5 Glomerular filtration rate (ml/min/1.73m 2 ) Current smokers (%) ± 25.3 Acute myocardial infarction 3.4% Stroke 2.4% CV death 1.5%

7 Event rate (%) Results - ASCVD (II) % % 9.0% Observed events Expected events % 0 <5% 5-<7.5% 7.5-<10% 10% ASCVD risk group

8 Event rate (%) Results - SCORE (II) % % Observed events Expected events % % <1% 1-<5% 5-<10% 10% SCORE risk group

9 Risk SCORE and ASCVD SCORE<5% % SCORE 5% Age (years) 46.6 ± ± 6.8 Male (%) Systolic blood pressure (mmhg) ± ± 24.1 Diastolic blood pressure (mmhg) 83.8± ± 9.7 Antihypertensive treatment (%) Type 2 diabetes (%) Body mass index (kg/m 2 ) 28.1 ± ± 3.5 Total cholesterol (mg/dl) ± ± 85.7 Low density lipoprotein-c (mg/dl) ± ± 74.6 Statin treatment (%) Current smokers (%) ASCVD<7.5% ASCVD 7.5% ± ± ± ± ± ± ± ± ± ± ± ±

10 Discussion In our cohort, the predicted CV risks are larger than the actual event rate patients under anti-dyslipidemic therapy in a Lipidology Clinic Matter for concern? overestimation in the highest levels of CV disease risk it s not problematic In patients with lower predicted risk >> undue prescription! Safety? Lloyd-Jones DM et al., Statins, risk assessment, and the new American prevention guidelines. Lancet. 2014

11 Event Event rate rate (%) (%) Discussion Risk overestimation in Czech Republic and Poland Vikhireva O et al., SCORE performance in Central and Eastern Europe and former Soviet Union: MONICA and HAPIEE results. Eur Heart J Observed events Expected Observed events events Expected events <5% 5-<7.5% 7.5-<10% 10% ASCVD risk group <1% 1-<5% 5-<10% 10% SCORE risk group

12 Discussion (II) Expected event rates were increased by % compared with the observed rates in three large-scale primary prevention cohorts, roughly doubling the actual observed risk; Possible explanation: the external validation cohorts are more contemporary than the original populations of the risk prediction algorithm, with improvements in healthcare Ridker PM et al., Statins: new American guidelines for prevention of cardiovascular disease. Lancet. 2013

13 Discussion (III) New guidelines: 56 million Americans (48.6%) would be eligible for statin Net increase of 12.8 million potential new statin users (+11.1%) over the previous guidelines Increased sensivity but decreased specificity Pencina MJ et al., Application of new cholesterol guidelines to a population-based sample. N Engl J Med Europe: men years old at risk according to ACC/AHA criteria versus European recommendations 30 times more! Vaucher J et al., Population and economic impact of the 2013 ACC/AHA guidelines compared with European guidelines to prevent cardiovascular disease. Eur Heart J. 2014

14 Conclusion In a large real-life European cohort of patients under anti-dyslipidemic therapy: The predicted CV risks (SCORE and ASCVD) are superior to the actual event rate The 7.5% recommended cut-off point of the ASCVD calculator is extremely effective in discriminating highrisk subjects

15 References Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, et al. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur Heart J Jul;33(13): Catapano AL, Reiner Z, De Backer G, Graham I, Taskinen MR, Wiklund O, et al. ESC/EAS Guidelines for the management of dyslipidaemias The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Atherosclerosis Jul;217(1):3-46. Goff DC, Jr., Lloyd-Jones DM, Bennett G, O'Donnell CJ, Coady S, Robinson J, et al ACC/AHA Guideline on the Assessment of Cardiovascular Risk: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology Nov 12. Yusuf S, Dagenais G, Pogue J, Bosch J, Sleight P. Vitamin E supplementation and cardiovascular events in high-risk patients. The Heart Outcomes Prevention Evaluation Study Investigators. N Engl J Med Jan 20;342(3): Stone NJ, Robinson J, Lichtenstein AH, Bairey Merz CN, Lloyd-Jones DM, Blum CB, et al ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology Nov 7. Vikhireva O, Pajak A, Broda G, Malyutina S, Tamosiunas A, Kubinova R, et al. SCORE performance in Central and Eastern Europe and former Soviet Union: MONICA and HAPIEE results. Eur Heart J Mar;35(9): Vaucher J, Marques-Vidal P, Preisig M, Waeber G, Vollenweider P. Population and economic impact of the 2013 ACC/AHA guidelines compared with European guidelines to prevent cardiovascular disease. Eur Heart J Feb 25. Conroy RM, Pyorala K, Fitzgerald AP, Sans S, Menotti A, De Backer G, et al. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J Jun;24(11): Keaney JF, Jr., Curfman GD, Jarcho JA. A pragmatic view of the new cholesterol treatment guidelines. N Engl J Med Jan 16;370(3): Ridker PM, Cook NR. Statins: new American guidelines for prevention of cardiovascular disease. Lancet Nov 30;382(9907): Pencina MJ, Navar-Boggan AM, D'Agostino RB, Sr., Williams K, Neely B, Sniderman AD, et al. Application of new cholesterol guidelines to a population-based sample. N Engl J Med Apr 10;370(15):

16 XXXV Congresso Português de Cardiologia The brand new AHA/ACC 2013 cardiovascular risk calculator: is it applicable to a low-risk southern European population? Manuel Oliveira-Santos, Rui Baptista, Marta Rebelo, Diana Oliveira, Patrícia Dias, Rui Martins, José Pereira de Moura, Mariano Pêgo Serviço de Cardiologia A Serviço de Medicina Interna A

MANAGEMENT OF LIPID DISORDERS: IMPLICATIONS OF THE NEW GUIDELINES

MANAGEMENT OF LIPID DISORDERS: IMPLICATIONS OF THE NEW GUIDELINES MANAGEMENT OF LIPID DISORDERS: IMPLICATIONS OF THE NEW GUIDELINES Robert B. Baron MD MS Professor and Associate Dean UCSF School of Medicine Declaration of full disclosure: No conflict of interest EXPLAINING

More information

HYPERCHOLESTEROLAEMIA STATIN AND BEYOND

HYPERCHOLESTEROLAEMIA STATIN AND BEYOND HYPERCHOLESTEROLAEMIA STATIN AND BEYOND Andrea Luk Division of Endocrinology Department of Medicine & Therapeutics The Chinese University of Hong Kong HA Convention 4 May 2016 Statins reduce CVD and all-cause

More information

EUROASPIRE II. European Action on Secondary and Primary Prevention through Intervention to Reduce Events

EUROASPIRE II. European Action on Secondary and Primary Prevention through Intervention to Reduce Events II European Action on Secondary and Primary Prevention through Intervention to Reduce Events Euro Heart Survey Programme European Society of Cardiology-ESC 1 2 Priorities of Coronary Heart Disease Prevention

More information

JNC-8 Blood Pressure and ACC/AHA Cholesterol Guideline Updates. January 30, 2014

JNC-8 Blood Pressure and ACC/AHA Cholesterol Guideline Updates. January 30, 2014 JNC-8 Blood Pressure and ACC/AHA Cholesterol Guideline Updates January 30, 2014 GOALS Review key recommendations from recently published guidelines on blood pressure and cholesterol management Discuss

More information

Journal Club: Niacin in Patients with Low HDL Cholesterol Levels Receiving Intensive Statin Therapy by the AIM-HIGH Investigators

Journal Club: Niacin in Patients with Low HDL Cholesterol Levels Receiving Intensive Statin Therapy by the AIM-HIGH Investigators Journal Club: Niacin in Patients with Low HDL Cholesterol Levels Receiving Intensive Statin Therapy by the AIM-HIGH Investigators Shaikha Al Naimi Doctor of Pharmacy Student College of Pharmacy Qatar University

More information

Main Effect of Screening for Coronary Artery Disease Using CT

Main Effect of Screening for Coronary Artery Disease Using CT Main Effect of Screening for Coronary Artery Disease Using CT Angiography on Mortality and Cardiac Events in High risk Patients with Diabetes: The FACTOR-64 Randomized Clinical Trial Joseph B. Muhlestein,

More information

New Cholesterol Guidelines: Carte Blanche for Statin Overuse Rita F. Redberg, MD, MSc Professor of Medicine

New Cholesterol Guidelines: Carte Blanche for Statin Overuse Rita F. Redberg, MD, MSc Professor of Medicine New Cholesterol Guidelines: Carte Blanche for Statin Overuse Rita F. Redberg, MD, MSc Professor of Medicine Disclosures & Relevant Relationships I have nothing to disclose No financial conflicts Editor,

More information

2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Athersclerotic Risk

2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Athersclerotic Risk 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Athersclerotic Risk Lynne T Braun, PhD, CNP, FAHA, FAAN Professor of Nursing, Nurse Practitioner Rush University Medical Center 2

More information

Statins and Risk for Diabetes Mellitus. Background

Statins and Risk for Diabetes Mellitus. Background Statins and Risk for Diabetes Mellitus Kevin C. Maki, PhD, FNLA Midwest Center for Metabolic & Cardiovascular Research and DePaul University, Chicago, IL 1 Background In 2012 the US Food and Drug Administration

More information

How To Prevent A Cardiovascular Event

How To Prevent A Cardiovascular Event The Challenges and Benefits of Cardiovascular Risk Assessment in Clinical Practice Steven A Grover MD, MPA From the McGill Cardiovascular Health Improvement Program and the Divisions of General Internal

More information

Systolic Blood Pressure Intervention Trial (SPRINT) Principal Results

Systolic Blood Pressure Intervention Trial (SPRINT) Principal Results Systolic Blood Pressure Intervention Trial (SPRINT) Principal Results Paul K. Whelton, MB, MD, MSc Chair, SPRINT Steering Committee Tulane University School of Public Health and Tropical Medicine, and

More information

The Canadian Association of Cardiac

The Canadian Association of Cardiac Reinventing Cardiac Rehabilitation Outside of acute care institutions, cardiovascular disease is a chronic, inflammatory process; the reduction or elimination of recurrent acute coronary syndromes is a

More information

Assessing risk of myocardial infarction and stroke: new data from the Prospective Cardiovascular Münster (PROCAM) study

Assessing risk of myocardial infarction and stroke: new data from the Prospective Cardiovascular Münster (PROCAM) study European Journal of Clinical Investigation (2007) 37, 925 932 DOI: 10.1111/j.1365-2362.2007.01888.x Blackwell Publishing Ltd Review Assessing risk of myocardial infarction and stroke: new data from the

More information

Prescription Cholesterol-lowering Medication Use in Adults Aged 40 and Over: United States, 2003 2012

Prescription Cholesterol-lowering Medication Use in Adults Aged 40 and Over: United States, 2003 2012 NCHS Data Brief No. 77 December 4 Prescription Cholesterol-lowering Medication Use in Adults Aged 4 and Over: United States, 3 2 Qiuping Gu, M.D., Ph.D.; Ryne Paulose-Ram, Ph.D., M.A.; Vicki L. Burt, Sc.M.,

More information

Making Sense of the New Statin guidelines. They are more than just lowering your cholesterol!

Making Sense of the New Statin guidelines. They are more than just lowering your cholesterol! Making Sense of the New Statin guidelines They are more than just lowering your cholesterol! No Disclosures Margaret (Peg) O Donnell DNPs, FNP, ANP B-C, FAANP Senior Nurse Practitioner South Nassau Communities

More information

The Link Between Obesity and Diabetes The Rapid Evolution and Positive Results of Bariatric Surgery

The Link Between Obesity and Diabetes The Rapid Evolution and Positive Results of Bariatric Surgery The Link Between Obesity and Diabetes The Rapid Evolution and Positive Results of Bariatric Surgery Michael E. Farkouh, MD, MSc Peter Munk Chair in Multinational Clinical Trials Director, Heart and Stroke

More information

Cohort Studies. Sukon Kanchanaraksa, PhD Johns Hopkins University

Cohort Studies. Sukon Kanchanaraksa, PhD Johns Hopkins University This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike License. Your use of this material constitutes acceptance of that license and the conditions of use of materials on this

More information

ADVANCE: a factorial randomised trial of blood pressure lowering and intensive glucose control in 11,140 patients with type 2 diabetes

ADVANCE: a factorial randomised trial of blood pressure lowering and intensive glucose control in 11,140 patients with type 2 diabetes ADVANCE: a factorial randomised trial of blood pressure lowering and intensive glucose control in 11,140 patients with type 2 diabetes Effects of a fixed combination of the ACE inhibitor, perindopril,

More information

International Task Force for Prevention Of Coronary Heart Disease. Clinical management of risk factors. coronary heart disease (CHD) and stroke

International Task Force for Prevention Of Coronary Heart Disease. Clinical management of risk factors. coronary heart disease (CHD) and stroke International Task Force for Prevention Of Coronary Heart Disease Clinical management of risk factors of coronary heart disease and stroke Economic analyses of primary prevention of coronary heart disease

More information

DISCLOSURES RISK ASSESSMENT. Stroke and Heart Disease -Is there a Link Beyond Risk Factors? Daniel Lackland, MD

DISCLOSURES RISK ASSESSMENT. Stroke and Heart Disease -Is there a Link Beyond Risk Factors? Daniel Lackland, MD STROKE AND HEART DISEASE IS THERE A LINK BEYOND RISK FACTORS? D AN IE L T. L AC K L AN D DISCLOSURES Member of NHLBI Risk Assessment Workgroup RISK ASSESSMENT Count major risk factors For patients with

More information

2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults

2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation,

More information

Predictive Value of the Framingham Risk Score in Identifying High Cardiovascular Risk

Predictive Value of the Framingham Risk Score in Identifying High Cardiovascular Risk 4 Internacional Journal of Cardiovascular Sciences. 2015;28(1):4-8 ORIGINAL MANUSCRIPT Predictive Value of the Framingham Risk Score in Identifying High Cardiovascular Risk Priscila Valente Fernandes 1,

More information

Design and principal results

Design and principal results International Task Force for Prevention Of Coronary Heart Disease Coronary heart disease and stroke: Risk factors and global risk Slide Kit 1 (Prospective Cardiovascular Münster Heart Study) Design and

More information

HeartScore Web - based version users guide TABLE OF CONTENTS. 1. Preamble... 2. 2. Benefits of using HeartScore... 2. 3. Accessing HeartScore...

HeartScore Web - based version users guide TABLE OF CONTENTS. 1. Preamble... 2. 2. Benefits of using HeartScore... 2. 3. Accessing HeartScore... TABLE OF CONTENTS 1. Preamble... 2 2. Benefits of using HeartScore... 2 3. Accessing HeartScore... 2 4. HeartScore Web Based Homepage... 3 5. Patient Card... 4 6. Create a new examination... 6 7. Examination

More information

PREVENTIVE CARDIOLOGY CURRICULUM. Overview

PREVENTIVE CARDIOLOGY CURRICULUM. Overview PREVENTIVE CARDIOLOGY CURRICULUM Overview The primary goal of the Preventive Cardiology curriculum for the University of Wisconsin Cardiovascular Medicine Fellowship is to provide the knowledge and skills

More information

Prognostic impact of uric acid in patients with stable coronary artery disease

Prognostic impact of uric acid in patients with stable coronary artery disease Prognostic impact of uric acid in patients with stable coronary artery disease Gjin Ndrepepa, Siegmund Braun, Martin Hadamitzky, Massimiliano Fusaro, Hans-Ullrich Haase, Kathrin A. Birkmeier, Albert Schomig,

More information

ROLE OF LDL CHOLESTEROL, HDL CHOLESTEROL AND TRIGLYCERIDES IN THE PREVENTION OF CORONARY HEART DISEASE AND STROKE

ROLE OF LDL CHOLESTEROL, HDL CHOLESTEROL AND TRIGLYCERIDES IN THE PREVENTION OF CORONARY HEART DISEASE AND STROKE ROLE OF LDL CHOLESTEROL, HDL CHOLESTEROL AND TRIGLYCERIDES IN THE PREVENTION OF CORONARY HEART DISEASE AND STROKE I- BACKGROUND: Coronary artery disease and stoke are the major killers in the United States.

More information

African Americans & Cardiovascular Diseases

African Americans & Cardiovascular Diseases Statistical Fact Sheet 2013 Update African Americans & Cardiovascular Diseases Cardiovascular Disease (CVD) (ICD/10 codes I00-I99, Q20-Q28) (ICD/9 codes 390-459, 745-747) Among non-hispanic blacks age

More information

Guidelines for the management of hypertension in patients with diabetes mellitus

Guidelines for the management of hypertension in patients with diabetes mellitus Guidelines for the management of hypertension in patients with diabetes mellitus Quick reference guide In the Eastern Mediterranean Region, there has been a rapid increase in the incidence of diabetes

More information

How To Treat Dyslipidemia

How To Treat Dyslipidemia An International Atherosclerosis Society Position Paper: Global Recommendations for the Management of Dyslipidemia Introduction Executive Summary The International Atherosclerosis Society (IAS) here updates

More information

Cardiac Assessment for Renal Transplantation: Pre-Operative Clearance is Only the Tip of the Iceberg

Cardiac Assessment for Renal Transplantation: Pre-Operative Clearance is Only the Tip of the Iceberg Cardiac Assessment for Renal Transplantation: Pre-Operative Clearance is Only the Tip of the Iceberg 2 nd Annual Duke Renal Transplant Symposium March 1, 2014 Durham, NC Joseph G. Rogers, M.D. Associate

More information

Research Article Cardiovascular Risk in Psoriasis: A Population-Based Analysis with Assessment of the Framingham Risk Score

Research Article Cardiovascular Risk in Psoriasis: A Population-Based Analysis with Assessment of the Framingham Risk Score Scientifica Volume 2013, Article ID 371569, 4 pages http://dx.doi.org/10.1155/2013/371569 Research Article Cardiovascular Risk in Psoriasis: A Population-Based Analysis with Assessment of the Framingham

More information

Evaluating the impact of population and high-risk strategies for the primary prevention of cardiovascular disease

Evaluating the impact of population and high-risk strategies for the primary prevention of cardiovascular disease European Heart Journal (24) 25, 484 491 Clinical research Evaluating the impact of population and high-risk strategies for the primary prevention of cardiovascular disease Jonathan Emberson a, *, Peter

More information

Research Skills for Non-Researchers: Using Electronic Health Data and Other Existing Data Resources

Research Skills for Non-Researchers: Using Electronic Health Data and Other Existing Data Resources Research Skills for Non-Researchers: Using Electronic Health Data and Other Existing Data Resources James Floyd, MD, MS Sep 17, 2015 UW Hospital Medicine Faculty Development Program Objectives Become more

More information

Absolute cardiovascular disease risk assessment

Absolute cardiovascular disease risk assessment Quick reference guide for health professionals Absolute cardiovascular disease risk assessment This quick reference guide is a summary of the key steps involved in assessing absolute cardiovascular risk

More information

Evidence-Based Secondary Stroke Prevention and Adherence to Guidelines

Evidence-Based Secondary Stroke Prevention and Adherence to Guidelines Evidence-Based Secondary Stroke Prevention and Adherence to Guidelines Mitchell S.V. Elkind, MD, MS Associate Professor of Neurology Columbia University New York, NY Presenter Disclosure Information Mitchell

More information

Risk Factors in Singapore Med J 2011-2012

Risk Factors in Singapore Med J 2011-2012 Review Article Singapore Med J 2011; 52(2) : 116 Review of tools of cardiovascular disease risk stratification: interpretation, customisation and application in clinical practice Chia Y C Department of

More information

Multiple comorbidities: additive and predictive of cardiovascular risk. Peter M. Nilsson Lund University University Hospital Malmö, Sweden

Multiple comorbidities: additive and predictive of cardiovascular risk. Peter M. Nilsson Lund University University Hospital Malmö, Sweden Multiple comorbidities: additive and predictive of cardiovascular risk Peter M. Nilsson Lund University University Hospital Malmö, Sweden Clinical outcomes: major complications of CVD Heart Attack/ACS

More information

Will The Coronary Calcium Score Affect the Decision To Treat With Statins?

Will The Coronary Calcium Score Affect the Decision To Treat With Statins? Will The Coronary Calcium Score Affect the Decision To Treat With Statins? Amresh Raina M.D. Division of Cardiology University of Pennsylvania Disclosures No financial relationships relevant to this presentation

More information

Stroke Prevention in Primary Care

Stroke Prevention in Primary Care Stroke Prevention in Primary Care ANNE LINDSTROM, APN, FNP-BC, SCRN Disclosures I have no disclosures. Objectives Describe tools available to estimate patient risk of stroke Review non-modifiable risk

More information

Overview and update of modern type 2 Diabetes philosophy and management. Dr Steve Stanaway Consultant Endocrinologist BCU

Overview and update of modern type 2 Diabetes philosophy and management. Dr Steve Stanaway Consultant Endocrinologist BCU Overview and update of modern type 2 Diabetes philosophy and management Dr Steve Stanaway Consultant Endocrinologist BCU Diabetes economics 2009: 2.6M adults with DM in UK (90% type 2) 2025: est. > 4M

More information

Associate Professor Patrick Kay Interventional cardiologist Middlemore, Auckland and Mercy Hospitals Auckland

Associate Professor Patrick Kay Interventional cardiologist Middlemore, Auckland and Mercy Hospitals Auckland Associate Professor Patrick Kay Interventional cardiologist Middlemore, Auckland and Mercy Hospitals Auckland 14:00-14:55 WS #45: New Therapies for Lipid Management 15:05-16:00 WS #57: New Therapies for

More information

Assessment and Management of Cardiovascular Risks in Women

Assessment and Management of Cardiovascular Risks in Women Checklist for effective cardiovascular risk evaluation ESC Task Force on Gender Initial consultation Family history Cigarettes/day Alcohol consumption Menopausal status Age Chronic kidney disease Diabetes

More information

2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY

2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY Measure #317: Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented National Quality Strategy Domain: Community / Population Health 2016 PQRS OPTIONS F INDIVIDUAL MEASURES:

More information

BMC Med 7/19/2007; Simvastatin linked to reduced incidence of dementia, Parkinson s disease.

BMC Med 7/19/2007; Simvastatin linked to reduced incidence of dementia, Parkinson s disease. March 3, 2012 BD Response to FDA statement regarding Statins The Food and Drug Administration announced on Tuesday (February 28, 2012) the changes to the safety information on the labels of statins regarding

More information

Use of cholesterol lowering drugs could be improved further:

Use of cholesterol lowering drugs could be improved further: ORIGINAL REPORT ERKKI VARTIAINEN M.D., Ph.D., Professor, Assistant Director General erkki.vartiainen@thl.fi TIINA LAATIKAINEN M.D., Ph.D., Chief Physician, Director of Department TIMO STRANDBERG M.D.,

More information

Assessing Cardiovascular Risk

Assessing Cardiovascular Risk Assessing Cardiovascular Risk Systematic Evidence Review From the Risk Assessment Work Group, 2013 Contents Foreword... v Risk Assessment Work Group... vi Section 1: Background and Description of the

More information

High Blood Cholesterol

High Blood Cholesterol National Cholesterol Education Program ATP III Guidelines At-A-Glance Quick Desk Reference 1 Step 1 2 Step 2 3 Step 3 Determine lipoprotein levels obtain complete lipoprotein profile after 9- to 12-hour

More information

Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II).

Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II). Complete Summary GUIDELINE TITLE (1)Third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment

More information

MY TYPE 2 DIABETES NUMBERS

MY TYPE 2 DIABETES NUMBERS BLOOD SUGAR MANAGEMENT GUIDE MY TYPE 2 DIABETES NUMBERS Understanding and Tracking the ABCs of Type 2 Diabetes 1 BLOOD MY TYPE SUGAR 2 DIABETES MANAGEMENT ABC NUMBERS GUIDE When you have type 2 diabetes,

More information

Predictive value of clinical risk assessment tools and guidelines for 10-year coronary heart disease risk in practice-based primary care

Predictive value of clinical risk assessment tools and guidelines for 10-year coronary heart disease risk in practice-based primary care Kardiovaskuläre Medizin 2005;8:180 186 Michel J. Romanens a, David C. Berger b, Edouard J. Battegay c a b c RODIAG Diagnostic Centers, Olten, Switzerland Student, University Hospital, Basel, Switzerland

More information

EPA/DHA Omega-3 Fatty Acids in the Primary and Secondary Prevention of Cardiovascular Disease and the Modification of Risk Factors

EPA/DHA Omega-3 Fatty Acids in the Primary and Secondary Prevention of Cardiovascular Disease and the Modification of Risk Factors EPA/DHA Omega-3 Fatty Acids in the Primary and Secondary Prevention of Cardiovascular Disease and the Modification of Risk Factors Author: Bruce Holub, Ph.D. University Professor Emeritus (University of

More information

SUMMARY OF CHANGES TO QOF 2015/16 - ENGLAND CLINICAL

SUMMARY OF CHANGES TO QOF 2015/16 - ENGLAND CLINICAL SUMMARY OF CHANGES TO QOF 2015/1 - ENGLAND KEY No change Retired/replaced Wording and/or change Point or threshold change Indicator ID change 14/15 QOF ID 15/1 QOF ID NICE ID Indicator wording Changes

More information

Isabella Sudano & Franco Muggli

Isabella Sudano & Franco Muggli Swiss Hypertension Guidelines Isabella Sudano & Franco Muggli CoLaus, Swisshype ESC 2005 Dokumentenname Datum Seite 1 European Journal of Cardiovascular Prevention and Rehabilitation 2009 Guideline...

More information

Appendix: Description of the DIETRON model

Appendix: Description of the DIETRON model Appendix: Description of the DIETRON model Much of the description of the DIETRON model that appears in this appendix is taken from an earlier publication outlining the development of the model (Scarborough

More information

2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults

2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults Accepted Manuscript 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults Neil J. Stone, MD, MACP, FAHA, FACC Jennifer Robinson, MD, MPH,

More information

An Introduction to Medication Adherence

An Introduction to Medication Adherence An Introduction to Medication Adherence Medication Adherence Project (MAP) A project of the Cardiovascular Prevention & Control Program and the Fund for Public Health in New York Drugs don t work in patients

More information

Management of Lipids in 2015: Just Give them a Statin?

Management of Lipids in 2015: Just Give them a Statin? Management of Lipids in 2015: Just Give them a Statin? James H. Stein, M.D. Division of Cardiovascular Medicine University of Wisconsin School of Medicine and Public Health Stone NJ, et al. Circulation

More information

Know your Numbers The D5 Goals for Diabetes Care. Shelly Hanson RN, CNS, CDE Cuyuna Regional Medical Center November 6, 2014

Know your Numbers The D5 Goals for Diabetes Care. Shelly Hanson RN, CNS, CDE Cuyuna Regional Medical Center November 6, 2014 Know your Numbers The D5 Goals for Diabetes Care Shelly Hanson RN, CNS, CDE Cuyuna Regional Medical Center November 6, 2014 The D5 What is it 5 different treatment goals identified for optimal diabetes

More information

2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk

2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk Accepted Manuscript 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk David C. Goff, MD, PhD, FACP, FAHA Donald M. Lloyd-Jones, MD, ScM, FACC, FAHA Glen Bennett, MPH Christopher J. O Donnell,

More information

PRACTICE PROBLEMS FOR BIOSTATISTICS

PRACTICE PROBLEMS FOR BIOSTATISTICS PRACTICE PROBLEMS FOR BIOSTATISTICS BIOSTATISTICS DESCRIBING DATA, THE NORMAL DISTRIBUTION 1. The duration of time from first exposure to HIV infection to AIDS diagnosis is called the incubation period.

More information

Mortality Assessment Technology: A New Tool for Life Insurance Underwriting

Mortality Assessment Technology: A New Tool for Life Insurance Underwriting Mortality Assessment Technology: A New Tool for Life Insurance Underwriting Guizhou Hu, MD, PhD BioSignia, Inc, Durham, North Carolina Abstract The ability to more accurately predict chronic disease morbidity

More information

Vilken evidens finns för att blodtrycksmålet 130/80 mmhg leder till färre komplikationer än systoliskt blodtryck under 140 mmhg vid DM2?

Vilken evidens finns för att blodtrycksmålet 130/80 mmhg leder till färre komplikationer än systoliskt blodtryck under 140 mmhg vid DM2? Kardiovaskulära Vårmötet Örebro 2011 Vilken evidens finns för att blodtrycksmålet 130/80 mmhg leder till färre komplikationer än systoliskt blodtryck under 140 mmhg vid DM2? Peter M Nilsson Institutionen

More information

Coronary heart disease (CHD) has an enormous

Coronary heart disease (CHD) has an enormous GLOBAL RISK ASSESSMENT IN CARDIOVASCULAR DISEASE * Steven P. Schulman, MD ABSTRACT Cardiovascular disease is the leading cause of mortality in the United States. Importantly, atherosclerosis begins at

More information

Submitted Electronically to AdvanceNotice2016@cms.hhs.gov

Submitted Electronically to AdvanceNotice2016@cms.hhs.gov March 6, 2015 Marilyn Tavenner, RN, BSN, MHA Administrator Centers for Medicare & Medicaid Services Department of Health and Human Services 200 Independence Avenue, SW Washington, D.C. 20201 Submitted

More information

Cardiovascular risk assessment: Audit findings from a nurse clinic a quality improvement initiative

Cardiovascular risk assessment: Audit findings from a nurse clinic a quality improvement initiative Cardiovascular risk assessment: Audit findings from a nurse clinic a quality improvement initiative Sarah Waldron RN, PG Dip (Adv Ng); Margaret Horsburgh RN, EdD, MA (Hons), Dip Ed, FCNA(NZ) School of

More information

Nierfunctiemeting en follow-up van chronisch nierlijden

Nierfunctiemeting en follow-up van chronisch nierlijden Nierfunctiemeting en follow-up van chronisch nierlijden 12 Jan 2016 Patrick Peeters, M.D. Dept Nephrology Ghent University Hospital Plan of presentation 1/ Renal function determination: Measured GFR Estimated

More information

Coronary Heart Disease (CHD) Brief

Coronary Heart Disease (CHD) Brief Coronary Heart Disease (CHD) Brief What is Coronary Heart Disease? Coronary Heart Disease (CHD), also called coronary artery disease 1, is the most common heart condition in the United States. It occurs

More information

Primary Care Management of Women with Hyperlipidemia. Julie Marfell, DNP, BC, FNP, Chairperson, Department of Family Nursing

Primary Care Management of Women with Hyperlipidemia. Julie Marfell, DNP, BC, FNP, Chairperson, Department of Family Nursing Primary Care Management of Women with Hyperlipidemia Julie Marfell, DNP, BC, FNP, Chairperson, Department of Family Nursing Objectives: Define dyslipidemia in women Discuss the investigation process leading

More information

Antioxidants and Heart Disease

Antioxidants and Heart Disease Antioxidants and Heart Disease Antioxidants help protect every cell and membrane in the body against the ravages of everyday living, and thus may help prevent diseases that result from accumulated damage

More information

COMMITTEE FOR MEDICINAL PRODUCTS FOR HUMAN USE (CHMP) GUIDELINE ON THE EVALUATION OF MEDICINAL PRODUCTS FOR CARDIOVASCULAR DISEASE PREVENTION

COMMITTEE FOR MEDICINAL PRODUCTS FOR HUMAN USE (CHMP) GUIDELINE ON THE EVALUATION OF MEDICINAL PRODUCTS FOR CARDIOVASCULAR DISEASE PREVENTION European Medicines Agency Pre-Authorisation Evaluation of Medicines for Human Use London, 25 September 2008 Doc. Ref. EMEA/CHMP/EWP/311890/2007 COMMITTEE FOR MEDICINAL PRODUCTS FOR HUMAN USE (CHMP) GUIDELINE

More information

Aggressive Lowering of Blood Pressure in type 2 Diabetes Mellitus: The Diastolic Cost

Aggressive Lowering of Blood Pressure in type 2 Diabetes Mellitus: The Diastolic Cost Aggressive Lowering of Blood Pressure in type 2 Diabetes Mellitus: The Diastolic Cost Naftali Stern Institute of Endocrinology, Metabolism and Hypertension Tel Aviv -Sourasky Medical Center and Sackler

More information

Prescription Pattern of Anti Hypertensive Drugs used in Hypertensive Patients with Associated Type2 Diabetes Mellitus in A Tertiary Care Hospital

Prescription Pattern of Anti Hypertensive Drugs used in Hypertensive Patients with Associated Type2 Diabetes Mellitus in A Tertiary Care Hospital Research Article Prescription Pattern of Anti Hypertensive Drugs used in Hypertensive Patients with Associated Type2 Diabetes Mellitus in A Tertiary Care Hospital *T. JANAGAN 1, R. KAVITHA 1, S. A. SRIDEVI

More information

The largest clinical study of Bayer's Xarelto (rivaroxaban) Wednesday, 14 November 2012 07:38

The largest clinical study of Bayer's Xarelto (rivaroxaban) Wednesday, 14 November 2012 07:38 Bayer HealthCare has announced the initiation of the COMPASS study, the largest clinical study of its oral anticoagulant Xarelto (rivaroxaban) to date, investigating the prevention of major adverse cardiac

More information

Understanding diabetes Do the recent trials help?

Understanding diabetes Do the recent trials help? Understanding diabetes Do the recent trials help? Dr Geoffrey Robb Consultant Physician and Diabetologist CMO RGA UK Services and Partnership Assurance AMUS 25 th March 2010 The security of experience.

More information

ESSENTIAL MESSAGES FROM ESC GUIDELINES

ESSENTIAL MESSAGES FROM ESC GUIDELINES ESSENTIAL MESSAGES FROM ESC GUIDELINES Committee for Practice Guidelines To improve the quality of clinical practice and patient care in Europe CVD PREVENTION FiFth Joint european societies task force

More information

Steven Allender, Peter Scarborough, Viv Peto and Mike Rayner

Steven Allender, Peter Scarborough, Viv Peto and Mike Rayner 2008 edition Steven Allender, Peter Scarborough, Viv Peto and Mike Rayner British Heart Foundation Health Promotion Research Group Department of Public Health, University of Oxford Jose Leal, Ramon Luengo-Fernandez

More information

CARDIAC REHABILITATION

CARDIAC REHABILITATION Paul Peacock Cardiac Rehabilitation Nurse Friday, 4 August 2006 1 The rehab Team Chris Murphy Kate O Reilly Paul Peacock Increased to 2 FTEs March 06 Wellington & Kapiti Coast MDT involvement Friday, 4

More information

Lipid levels in patients hospitalized with coronary artery disease: An analysis of 136,905 hospitalizations in Get With The Guidelines

Lipid levels in patients hospitalized with coronary artery disease: An analysis of 136,905 hospitalizations in Get With The Guidelines Lipid levels in patients hospitalized with coronary artery disease: An analysis of 136,905 hospitalizations in Get With The Guidelines Amit Sachdeva, MD, a Christopher P. Cannon, MD, b Prakash C. Deedwania,

More information

Effects of Cholesterol and Inflammation-Sensitive Plasma Proteins on Incidence of Myocardial Infarction and Stroke in Men

Effects of Cholesterol and Inflammation-Sensitive Plasma Proteins on Incidence of Myocardial Infarction and Stroke in Men Effects of Cholesterol and Inflammation-Sensitive Plasma Proteins on Incidence of Myocardial Infarction and Stroke in Men G. Engström, MD, PhD; P. Lind, MD; B. Hedblad, MD, PhD; L. Stavenow, MD, PhD; L.

More information

Metabolic Syndrome Overview: Easy Living, Bitter Harvest. Sabrina Gill MD MPH FRCPC Caroline Stigant MD FRCPC BC Nephrology Days, October 2007

Metabolic Syndrome Overview: Easy Living, Bitter Harvest. Sabrina Gill MD MPH FRCPC Caroline Stigant MD FRCPC BC Nephrology Days, October 2007 Metabolic Syndrome Overview: Easy Living, Bitter Harvest Sabrina Gill MD MPH FRCPC Caroline Stigant MD FRCPC BC Nephrology Days, October 2007 Evolution of Metabolic Syndrome 1923: Kylin describes clustering

More information

Analysis One Code Desc. Transaction Amount. Fiscal Period

Analysis One Code Desc. Transaction Amount. Fiscal Period Analysis One Code Desc Transaction Amount Fiscal Period 57.63 Oct-12 12.13 Oct-12-38.90 Oct-12-773.00 Oct-12-800.00 Oct-12-187.00 Oct-12-82.00 Oct-12-82.00 Oct-12-110.00 Oct-12-1115.25 Oct-12-71.00 Oct-12-41.00

More information

Centers for Medicare & Medicaid Services 7500 Security Boulevard Baltimore, MD 21244

Centers for Medicare & Medicaid Services 7500 Security Boulevard Baltimore, MD 21244 March 7, 2014 Centers for Medicare & Medicaid Services 7500 Security Boulevard Baltimore, MD 21244 Re: Dear Sir or Madam: On behalf of the American Heart Association (AHA), including the American Stroke

More information

At what coronary risk level is it cost-effective to initiate cholesterol lowering drug treatment in primary prevention?

At what coronary risk level is it cost-effective to initiate cholesterol lowering drug treatment in primary prevention? European Heart Journal (2001) 22, 919 925 doi:10.1053/euhj.2000.2484, available online at http://www.idealibrary.com on At what coronary risk level is it cost-effective to initiate cholesterol lowering

More information

COMMITTEE FOR HUMAN MEDICINAL PRODUCTS (CHMP) DRAFT GUIDELINE ON THE EVALUATION OF MEDICINAL PRODUCTS FOR CARDIOVASCULAR DISEASE PREVENTION

COMMITTEE FOR HUMAN MEDICINAL PRODUCTS (CHMP) DRAFT GUIDELINE ON THE EVALUATION OF MEDICINAL PRODUCTS FOR CARDIOVASCULAR DISEASE PREVENTION European Medicines Agency London, 19 July 2007 Doc. Ref. EMEA/CHMP/EWP/311890/2007 COMMITTEE FOR HUMAN MEDICINAL PRODUCTS (CHMP) DRAFT GUIDELINE ON THE EVALUATION OF MEDICINAL PRODUCTS FOR CARDIOVASCULAR

More information

Listen to your heart: Good Cardiovascular Health for Life

Listen to your heart: Good Cardiovascular Health for Life Listen to your heart: Good Cardiovascular Health for Life Luis R. Castellanos MD, MPH Assistant Clinical Professor of Medicine University of California San Diego School of Medicine Sulpizio Family Cardiovascular

More information

Anthony P. Morreale, Pharm.D., MBA, BCPS, Assistant Chief Consultant for Clinical Pharmacy Services and Healthcare Delivery Services Research of the

Anthony P. Morreale, Pharm.D., MBA, BCPS, Assistant Chief Consultant for Clinical Pharmacy Services and Healthcare Delivery Services Research of the Anthony P. Morreale, Pharm.D., MBA, BCPS, Assistant Chief Consultant for Clinical Pharmacy Services and Healthcare Delivery Services Research of the Department of Veterans Affairs. 1 12:03 12:08pm Introductions

More information

Measure #257 (NQF 1519): Statin Therapy at Discharge after Lower Extremity Bypass (LEB) National Quality Strategy Domain: Effective Clinical Care

Measure #257 (NQF 1519): Statin Therapy at Discharge after Lower Extremity Bypass (LEB) National Quality Strategy Domain: Effective Clinical Care Measure #257 (NQF 1519): Statin Therapy at Discharge after Lower Extremity Bypass (LEB) National Quality Strategy Domain: Effective Clinical Care 2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY

More information

Performance of Four Current Risk Algorithms in Predicting Cardiovascular Events in Patients With Early Rheumatoid Arthritis

Performance of Four Current Risk Algorithms in Predicting Cardiovascular Events in Patients With Early Rheumatoid Arthritis Performance of Four Current Risk Algorithms in Predicting Cardiovascular Events in Patients With Early Rheumatoid Arthritis E E A Arts, C Popa, A A Den Broeder, A G Semb, T Toms, G D Kitas, P L van Riel,

More information

Evidence-Based ACC/AHA Guidelines for Cardiovascular Risk Assessment

Evidence-Based ACC/AHA Guidelines for Cardiovascular Risk Assessment Evidence-Based ACC/AHA Guidelines for Cardiovascular Risk Assessment Nathan D. Wong, PhD, FACC, FAHA Professor and Director Heart Disease Prevention Program Division of Cardiology, University of CA, Irvine

More information

Cardiovascular Disease in Diabetes

Cardiovascular Disease in Diabetes Cardiovascular Disease in Diabetes Where Do We Stand in 2012? David M. Kendall, MD Distinguished Medical Fellow Lilly Diabetes Associate Professor of Medicine University of MInnesota Disclosure - Duality

More information

RECOMMENDATIONS Screen for CVD risk beginning at age 40 for men and 50 for women

RECOMMENDATIONS Screen for CVD risk beginning at age 40 for men and 50 for women PREVENTION AND MANAGEMENT OF CARDIOVASCULAR DISEASE RISK IN PRIMARY CARE Clinical Practice Guideline February 2015 OBJECTIVE Alberta primary care clinicians and their teams offer primary and secondary

More information

Pfizer Grant ID #045604

Pfizer Grant ID #045604 Educational Grant Application Designing an Electronic Medical Recorded-based Clinical Decision Support Tool To Improve CVD Screening in Rheumatoid Arthritis Patients Pfizer Grant ID #045604 Submitted to:

More information

Clinical Study The Sweet Spot: Continued Search for the Glycemic Threshold for Macrovascular Disease A Retrospective Single Center Experience

Clinical Study The Sweet Spot: Continued Search for the Glycemic Threshold for Macrovascular Disease A Retrospective Single Center Experience International Scholarly Research Network ISRN Cardiology Volume 2012, Article ID 874706, 5 pages doi:10.5402/2012/874706 Clinical Study The Sweet Spot: Continued Search for the Glycemic Threshold for Macrovascular

More information

PAYMENT INNOVATIONS SUPPORTING BEHAVIORAL HEALTHCARE DELIVERY IMPROVEMENT. NGA July 2015

PAYMENT INNOVATIONS SUPPORTING BEHAVIORAL HEALTHCARE DELIVERY IMPROVEMENT. NGA July 2015 PAYMENT INNOVATIONS SUPPORTING BEHAVIORAL HEALTHCARE DELIVERY IMPROVEMENT NGA July 2015 My Background Medicaid Director Previously DMH Medical Director 20 years Practicing Psychiatrist CMHCs 10 years FQHC

More information

Achieving Quality and Value in Chronic Care Management

Achieving Quality and Value in Chronic Care Management The Burden of Chronic Disease One of the greatest burdens on the US healthcare system is the rapidly growing rate of chronic disease. These statistics illustrate the scope of the problem: Nearly half of

More information

AT&T Global Network Client for Windows Product Support Matrix January 29, 2015

AT&T Global Network Client for Windows Product Support Matrix January 29, 2015 AT&T Global Network Client for Windows Product Support Matrix January 29, 2015 Product Support Matrix Following is the Product Support Matrix for the AT&T Global Network Client. See the AT&T Global Network

More information

Supplements, Vitamin D, Omega-3 Fatty Acids, and Co-Enzyme Q10: What Really Works?

Supplements, Vitamin D, Omega-3 Fatty Acids, and Co-Enzyme Q10: What Really Works? Supplements, Vitamin D, Omega-3 Fatty Acids, and Co-Enzyme Q10: What Really Works? DAVID P. GOWMAN, D.O. S E C T I O N CHIEF, CARDIOLOGY P R O G R A M D I R E C T O R, CARDIOLOGY F E L L O W S H I P B

More information

Cardiovascular Effects of Drugs to Treat Diabetes

Cardiovascular Effects of Drugs to Treat Diabetes Cardiovascular Effects of Drugs to Treat Diabetes Steven E. Nissen MD Chairman, Department of Cardiovascular Medicine Cleveland Clinic Disclosure Consulting: Many pharmaceutical companies Clinical Trials:

More information

Q1: Global risk assessment using PROCAM, SCORE, FRAMINGHAM or REYNOLDS ecc is sufficient YES NO NEED MORE DATA DISCUSS within Taskforce Your Comments

Q1: Global risk assessment using PROCAM, SCORE, FRAMINGHAM or REYNOLDS ecc is sufficient YES NO NEED MORE DATA DISCUSS within Taskforce Your Comments Site ID: Q1: Global risk assessment using PROCAM, SCORE, FRAMINGHAM or REYLDS ecc is sufficient Q2: The value of an emerging test is best assessed using C - statistics Q3: Atherosclerosis imaging may be

More information