Author Affiliations: Department of Internal Medicine/Cardiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina (Drs Yeboah and Herrington) (firstname.lastname@example.org); and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois (Dr Greenland).
In Reply: Our study showed the superiority of CAC for improving discrimination for incident CHD and CVD in individuals classified as intermediate risk by the Framingham risk score. We agree with Dr Kavousi and colleagues that contemporary CHD risk prediction models such as the Framingham risk score are not necessarily optimized to also predict CVD, which typically includes cerebrovascular outcomes in the composite definition. This is an important limitation to bear in mind as the scientific and clinical communities seek to broaden the scope of vascular disease outcomes that are targeted by prediction and prevention measures.
Yeboah J, Greenland P, Herrington DM. Markers for Prediction of Cardiovascular Disease Risk—Reply. JAMA. 2012;308(24):2561–2562. doi:10.1001/jama.2012.25796