2010 ACCF/AHA Guideline for Assessment of Cardiovascular Risk in Asymptomatic Adults: Executive Summary

Philip GreenlandProfessor of medicine and preventive medicine, Northwestern University

“Generally speaking, we haven't seen much evidence of improvement of risk prediction with the new markers when you look at the whole picture. The one exception, I would say, is measurement of coronary artery calcium. I came to this as a major skeptic about coronary calcium, and only after seeing some data did I come to believe that coronary calcium might actually have clinical impact. But even with coronary calcium, I think we're too early in the evaluation process to recommend routine use beyond standard risk measurement.”

Sidney C. Smith Jr.Professor of medicine, University of North Carolina Chapel Hill

“Genetic testing is a sexy area right now, but we didn't see it as being ready or as having shown added value.”

“Our enthusiasm about this victory for patients is tempered by the fact that the ACCF/AHA Task Force stopped short of an outright recommendation of the two atherosclerosis tests recommended by SHAPE. We believe the evidence is sufficient to recommend CACS or CIMT scanning for risk assessment of men 45-80 years of age and women 55-80 years of age who have a Framingham Risk Score of six percent or greater. By merely stating that a test 'is reasonable' or 'may be reasonable' depending on the circumstances, the ACCF/AHA Task Force has unnecessarily created uncertainty.”