Risk prediction tools in cardiovascular disease prevention: A report from the ESC Prevention of CVD Programme led by the European Association of Preventive Cardiology (EAPC) in collaboration with the Acute Cardiovascular Care Association (ACCA) and the Association of Cardiovascular Nursing and Allied Professions (ACNAP)

Abstract

Risk assessment and risk prediction have become essential in the prevention of cardiovascular disease. Even though risk prediction tools are recommended in the European guidelines, they are not adequately implemented in clinical practice. Risk prediction tools are meant to estimate prognosis in an unbiased and reliable way and to provide objective information on outcome probabilities. They support informed treatment decisions about the initiation or adjustment of preventive medication. Risk prediction tools facilitate risk communication to the patient and their family, and this may increase commitment and motivation to improve their health. Over the years many risk algorithms have been developed to predict 10-year cardiovascular mortality or lifetime risk in different populations, such as in healthy individuals, patients with established cardiovascular disease and patients with diabetes mellitus. Each risk algorithm has its own limitations, so different algorithms should be used in different patient populations. Risk algorithms are made available for use in clinical practice by means of – usually interactive and online available – tools. To help the clinician to choose the right tool for the right patient, a summary of available tools is provided. When choosing a tool, physicians should consider medical history, geographical region, clinical guidelines and additional risk measures among other things. Currently, the U-prevent.com website is the only risk prediction tool providing prediction algorithms for all patient categories, and its implementation in clinical practice is suggested/advised by the European Association of Preventive Cardiology.

Precision Nephrology Is a Non-Negligible State of Mind in Clinical Research: Remember the Past to Face the Future

“…A proof of this theory is represented by the inclusion in the modern CV risk prediction models computing 5- or 10-year CV risk, the information of response (or not response) to treatments together with the standard laboratory and clinical variables. This is done in the U-prevent CV risk calculator [64]. Novel “omics” techniques have demonstrated to be promising in detecting the specific pathopshysiological process in each patient that could be matched with a drug with an appropriate treatment.…”

“…Such self-assessed scores helped individuals to gain awareness about the underlying disease and the benefits of behavioral or prevention changes. Moreover, support to clinicians or patients for selecting the best prediction tools for each individual based on medical history, outcome measured, and methodological validation has also been provided [64]. Conversely, in the context of nephrology, the routine application of risk scores is still lacking, and this is determined by several cultural or practical obstacles [36].…”

Modern vision on the problem of chronic heart failure in the older persons

“…Лекарственные средства, используемые для лечения ХСН в старшем и в более молодом возрасте, аналогичны, хотя подбор лекарственной терапии у лиц пожилого и старческого возраста имеет отличительные черты из-за иной клинической симптоматики, особенностей обмена веществ, влияющих на фармакокинетику и фармакодинамику препаратов, высокого риска развития ортостатической гипотонии вследствие снижения чувствительности барорецепторов, сопутствующей патологии и гериатрических синдромов, что позволяет выделить наиболее уязвимые группы пациентов [42]:…”

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“…This challenge necessitates long-term cooperation not only between cardiologists, but also with general practitioners, therapeutics, neurologists, stroke physicians, vascular surgeons and other specialists. 5 Thus a multidimensional treatment and care approach across different specialisms remains key to improving outcomes. Here a consensus between experts from the European Society of Cardiology and the European Stroke Organisation and other related scientific societies underlined the need for interdisciplinary action in both the treatment and prevention of stroke.…”