Improving secondary cardiovascular risk prediction: taking a few steps along the long path from probability toward certainty

This editorial refers to ‘Identification of vascular patients at very high risk for recurrent cardiovascular events: validation of the current ACC/AHA very high risk criteria’, by M. van den Berg et al., doi: 10.1093/eurheartj/ehx102.

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The purpose of cardiovascular (CV) risk assessment tools is, by providing a probability of CV events over time, to segregate out populations into subgroups at varying degrees of CV risk. Those at high or very high risk may deserve particular attention in terms of preventive therapies, closer clinical follow-up, and resource allocation. In addition, risk stratification can be used to inform inclusion criteria in clinical trials. Primary prevention in atherosclerotic cardiovascular disease (ASCVD), for example, focuses on populations without clinical evidence of vascular disease (i.e. in coronary, cerebrovascular, or peripheral vascular beds). With...