The USPSTF Recommendation Statement on Coronary Heart Disease Risk Assessment
Authors: Michael J. Blaha
Journal: Annals of Internal Medicine (2010)

Letters16 March 2010The USPSTF Recommendation Statement on Coronary Heart Disease Risk AssessmentMichael J. Blaha, MD, MPH, Catherine Y. Campbell, MD, and Aaron Horne, MD, MBAMichael J. Blaha, MD, MPHFrom The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD 21287.Search for more papers by this author, Catherine Y. Campbell, MDFrom The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD 21287.Search for more papers by this author, and Aaron Horne, MD, MBAFrom The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD 21287.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-152-6-201003160-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We read with interest the USPSTF statement (1) on emerging risk factors for coronary heart disease (CHD). Specifically, the authors suggest that the current evidence does not support the use of CAC scoring “for further risk stratification of intermediate-risk persons.” The authors identify a 2004 study by Greenland and colleagues (2) as the “best-quality” study and suggest “flaws in the other studies.” This overall conclusion from the USPSTF is at odds with current recommendations from the AHA and ACC (2).Why was MESA not considered a high-quality study? The primary objective of MESA was “to determine characteristics ...References1. U.S. Preventive Services Task Force. Using nontraditional risk factors in coronary heart disease risk assessment: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2009;151:474-82. [PMID: 19805770] LinkGoogle Scholar2. Greenland P, Bonow RO, Brundage BH, Budoff MJ, Eisenberg MJ, Grundy SM, et al; American College of Cardiology Foundation Clinical Expert Consensus Task Force (ACCF/AHA Writing Committee to Update the 2000 Expert Consensus Document on Electron Beam Computed Tomography). ACCF/AHA 2007 clinical expert consensus document on coronary artery calcium scoring by computed tomography in global cardiovascular risk assessment and in evaluation of patients with chest pain: a report of the American College of Cardiology Foundation Clinical Expert Consensus Task Force (ACCF/AHA Writing Committee to Update the 2000 Expert Consensus Document on Electron Beam Computed Tomography). Circulation. 2007;115:402-26. [PMID: 17220398] MedlineGoogle Scholar3. Bild DE, Bluemke DA, Burke GL, Detrano R, Diez Roux AV, Folsom AR, et al. Multi-ethnic study of atherosclerosis: objectives and design. Am J Epidemiol. 2002;156:871-81. [PMID: 12397006] CrossrefMedlineGoogle Scholar4. Detrano R, Guerci AD, Carr JJ, Bild DE, Burke G, Folsom AR, et al. Coronary calcium as a predictor of coronary events in four racial or ethnic groups. N Engl J Med. 2008;358:1336-45. [PMID: 18367736] CrossrefMedlineGoogle Scholar5. Lakoski SG, Greenland P, Wong ND, Schreiner PJ, Herrington DM, Kronmal RA, et al. Coronary artery calcium scores and risk for cardiovascular events in women classified as “low risk” based on Framingham risk score: the multi-ethnic study of atherosclerosis (MESA). Arch Intern Med. 2007;167:2437-42. [PMID: 18071165] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Michael J. Blaha, MD, MPH; Catherine Y. Campbell, MD; Aaron Horne, MD, MBAAffiliations: From The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD 21287.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoUsing Nontraditional Risk Factors in Coronary Heart Disease Risk Assessment: U.S. Preventive Services Task Force Recommendation StatementThe USPSTF Recommendation Statement on Coronary Heart Disease Risk Assessment Eric L. Matteson , Cynthia S. Crowson , and Sherine E. Gabriel The USPSTF Recommendation Statement on Coronary Heart Disease Risk Assessment Ned Calonge and Diana Pettiti The USPSTF Recommendation Statement on Coronary Heart Disease Risk Assessment Robert J. Glynn The USPSTF Recommendation Statement on Coronary Heart Disease Risk Assessment Matthew J. Budoff Metrics 16 March 2010Volume 152, Issue 6Page: 404-405KeywordsArea under the curveCardiovascular diseasesCongenital heart diseaseCoronary artery calcificationCoronary heart diseaseLongitudinal studiesMedical risk factorsRisk assessmentsStable coronary artery diseaseStatins ePublished: 16 March 2010 Issue Published: 16 March 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...