ReviewHeart (British Cardiac Society)2011
Cardiovascular risk scores do not account for the effect of treatment: a review.
Review in Heart (British Cardiac Society), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed.
- Study of cardiovascular disease prediction model based on random forest in eastern China.Scientific reports · 2020Trial
- Trial
- Prediction of Cardiovascular Disease by the Framingham-REGICOR Equation in the High-Risk PREDIMED Cohort: Impact of the Mediterranean Diet Across Different Risk Strata.Journal of the American Heart Association · 2017Trial
- Blood-Based DNA Methylation Models Improve Short-term Cardiovascular Risk Stratification in Individuals With Type 2 Diabetes.Diabetes care · 2026Article
- Article
- Comparing predictive risk to actual presence of coronary atherosclerosis on coronary computed tomography angiography.American heart journal plus : cardiology research and practice · 2025Article
- Article
- Age and sex specific thresholds for risk stratification of cardiovascular disease and clinical decision making: prospective open cohort study.BMJ medicine · 2024Article
- Major Limitations of Cardiovascular Risk Scores.Cardiovascular therapeutics · 2024Review
- Prediction of the 10-year risk of atherosclerotic cardiovascular disease in the Korean population.Epidemiology and health · 2023Article
- Validation of Cardiovascular Risk Prediction by the Arriba Instrument.Deutsches Arzteblatt international · 2022Article
- Reduced cardiovascular morbidity in patients with hemophilia: results of a 5-year multinational prospective study.Blood advances · 2022Observational
- Invited Commentary: Treatment Drop-in-Making the Case for Causal Prediction.American journal of epidemiology · 2021Article
- Prediction of Cardiovascular Disease Risk Accounting for Future Initiation of Statin Treatment.American journal of epidemiology · 2021Article
- Omega-3 Fatty Acids in Erythrocyte Membranes as Predictors of Lower Cardiovascular Risk in Adults without Previous Cardiovascular Events.Nutrients · 2021Article
- A scoping review of causal methods enabling predictions under hypothetical interventions.Diagnostic and prognostic research · 2021Article
- Estimation of Major Adverse Cardiovascular Events in Patients With Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention: A Risk Prediction Score Model From a Derivation and Validation Study.Frontiers in cardiovascular medicine · 2020Article
- Cardiovascular risk prediction in India: Comparison of the original and recalibrated Framingham prognostic models in urban populations.Wellcome open research · 2019Article
- Using marginal structural models to adjust for treatment drop-in when developing clinical prediction models.Statistics in medicine · 2018Article
- Cardiovascular medication changes over 5 years in a national data linkage study: implications for risk prediction models.Clinical epidemiology · 2018Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo compare the strengths and limitations of cardiovascular risk scores available for clinicians in assessing the global (absolute) risk of cardiovascular disease.
designReview of cardiovascular risk scores. DATA SOURCES: Medline (1966 to May 2009) using a mixture of MeSH terms and free text for the keywords 'cardiovascular', 'risk prediction' and 'cohort studies'. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: A study was eligible if it fulfilled the following criteria: (1) it was a cohort study of adults in the general population with no prior history of cardiovascular disease and not restricted by a disease condition; (2) the primary objective was the development of a cardiovascular risk score/equation that predicted an individual's absolute cardiovascular risk in 5-10 years; (3) the score could be used by a clinician to calculate the risk for an individual patient.
results21 risk scores from 18 papers were identified from 3536 papers. Cohort size ranged from 4372 participants (SHS) to 1591209 records (QRISK2). More than half of the cardiovascular risk scores (11) were from studies with recruitment starting after 1980. Definitions and methods for measuring risk predictors and outcomes varied widely between scores. Fourteen cardiovascular risk scores reported data on prior treatment, but this was mainly limited to antihypertensive treatment. Only two studies reported prior use of lipid-lowering agents. None reported on prior use of platelet inhibitors or data on treatment drop-ins.
conclusionsThe use of risk-factor-modifying drugs-for example, statins-and disease-modifying medication-for example, platelet inhibitors-was not accounted for. In addition, none of the risk scores addressed the effect of treatment drop-ins-that is, treatment started during the study period. Ideally, a risk score should be derived from a population free from treatment. The lack of accounting for treatment effect and the wide variation in study characteristics, predictors and outcomes causes difficulties in the use of cardiovascular risk scores for clinical treatment decision.
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