A first step in overhauling cardiovascular risk prediction

September 22, 2015

An editorial published in the September issue of Circulation: Cardiovascular Quality and Outcomes lauded a recent research study for pursuing the challenging task of examining limitations to the current cardiovascular disease (CVD) events risk estimator.

Dr. Michael Pignone

Jamie Jarmul

Michael Pignone, MD, MPH, is an adjunct professor of health behavior at the UNC Gillings School of Global Public Health and a professor of medicine at UNC’s School of Medicine. He is a co-author of the study in question, along with Jamie Jarmul, a doctoral candidate in the Department of Health Policy and Management at the Gillings School.

The full article, titled “Interpreting Hemoglobin A1C in Combination With Conventional Risk Factors for Prediction of Cardiovascular Risk,” was published online Sept. 8 by Circulation: Cardiovascular Quality and Outcomes.

According to the study, CVD risk prediction tools are commonly used to help determine whether a patient at risk for cardiovascular events should begin a lifelong prescription for statins. It is currently unclear whether some assessment of diabetes or blood sugar level, like Hemoglobin A1C (HbA1C), should be included in CVD risk prediction tools.

Jarmul and Pignone’s study found that HbA1C does have modest effects on the predicted risk of CVD events when considered in the context of conventional risk factors. The study findings alone, however, are not significant enough to support adding HbA1C to conventional risk prediction.