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February 10, 1999

Prognostic Indicators for Coronary Artery Disease: Ready for the Bedside?

Author Affiliations

Author Affiliations: Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Md.

JAMA. 1999;281(6):565-566. doi:10.1001/jama.281.6.565

Identification of individuals at high risk for coronary events is a growing concern, reflecting increasing confidence in the capability of mechanical and pharmacological interventions to improve the outlook for coronary atherosclerosis. Numerous prognostic indicators have been proposed. Recently, physicians and the lay public have been inundated by advertisements for new tests aimed at identifying or excluding high coronary risk, with an implicit promise of a longer, better, less anxious life as the ultimate payoff.1,2 Validation of prognostic indices with a full understanding of their appropriate context and their implications for patient management are vitally important in formulating effective and efficient strategies for patient care. Inappropriate application of prognostic indices can lead to excessive use of costly and potentially injurious tests and therapies as well as needless patient anxiety.3,4