Cardiovascular Risk Prediction in Patients With Stable and Unstable Coronary Heart Disease

Risk assessment is essential to effective medical decision making for secondary prevention. A variety of clinical tools, including the most basic elements of the clinical history and the physical examination, provide valuable information on prognosis. In addition, data from the ECG, laboratory testing, and noninvasive and invasive imaging are complementary with respect to prognosis and can aid in informing patients and their families, directing triage, and guiding medical therapy. An integrated approach to risk assessment is optimal, and simple clinical risk scores can assist the clinician in assimilating the diverse sources of data on prognosis. Emerging tools for risk assessment continue to provide new insights into the pathogenesis of atherothrombosis and may advance the extent to which the promise of personalized preventive medicine can be realized in our routine care of patients with CV disease. Although discussed in the context of CHD, these principles are important to the full spectrum of patients with peripheral and cerebrovascular atherosclerotic disease. © 2010 American Heart Association, Inc.