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Invited Commentary
September 23, 2013

Echoing the Appropriate Use Criteria: The Role of Echocardiography for Cardiovascular Risk Assessment of the Asymptomatic Individual

Author Affiliations
  • 1Division of Cardiology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland
JAMA Intern Med. 2013;173(17):1598-1599. doi:10.1001/jamainternmed.2013.7029

Cardiovascular disease (CVD) is the leading cause of death in developed countries, and many who die suddenly of CVD have no previous symptoms.1 Therefore, there is great interest in identifying at-risk individuals so that appropriate preventive measures can be implemented. All asymptomatic adults should undergo global risk assessment. For carefully selected individuals deemed at intermediate risk, noninvasive imaging methods for measuring coronary artery calcium level or carotid intima–media thickness are additional tools for risk stratification, with class IIa indications (benefits exceed risks) in the 2010 American College of Cardiology Foundation/American Heart Association guidelines.2 Although predictive of risk above traditional risk factor assessment, it remains untested whether risk assessment with these or other tests directly produces changes in management that improve outcomes.

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