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Risk Prediction Scores in Cardiovascular Disease: Useful Tool or “Model of the Week”?

  • Christopher Maulion
    Affiliations
    Department of Internal Medicine, Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut
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  • James L. Januzzi
    Correspondence
    Reprint requests: James L. Januzzi, MD, Cardiology Division, Massachusetts General Hospital, 32 Fruit St, Yawkey 5984, Boston, MA 02114. Tel: +1 617 726 3443, Fax: +1 617 643 1620.
    Affiliations
    Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Baim Institute for Clinical Research, Boston, Massachusetts
    Search for articles by this author
      Cardiovascular disease, including heart failure (HF), is a major cause of morbidity and mortality in patients with chronic kidney disease (CKD).
      Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis.
      ,
      • Dhingra R.
      • Gaziano J.M.
      • Djousse L.
      Chronic kidney disease and the risk of heart failure in men.
      Furthermore, comorbid CKD and HF is associated with significantly worse outcomes.
      • Damman K.,
      • Testani J.M.
      The kidney in heart failure: an update.
      ,
      • Damman K.
      • et al.
      Renal impairment, worsening renal function, and outcome in patients with heart failure: an updated meta-analysis.
      Current guidelines emphasize the identification of high-risk individuals at risk for developing HF to maximize benefit of available interventions and prevent disease progression,
      • Yancy C.W.
      • Jessup M
      • Bozkurt B
      • Butler J
      • Casey Jr, DE
      • Colvin MM
      • et al.
      2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America.
      something particularly relevant with the recent emergence of sodium/glucose co-transporter-2 inhibitors or finerenone as beneficial cardiorenal therapies in those with proteinuric CKD, both decreasing HF events in affected patients.
      • Perkovic V.
      • Jardine MJ
      • Neal B
      • Bompoint S
      • Heerspink HJL
      • Charytan DM
      • et al.
      Canagliflozin and renal outcomes in type 2 diabetes and nephropathy.
      • Heerspink H.J.L.
      • Stefánsson BV
      • Correa-Rotter R
      • Chertow GM
      • Greene T
      • Hou FF
      • et al.
      Dapagliflozin in patients with chronic kidney disease.
      • Bakris G.L.
      • Agarwal R
      • Anker SD
      • Pitt B
      • Ruilope LM
      • Rossing P
      • et al.
      Effect of finerenone on chronic kidney disease outcomes in type 2 diabetes.
      • Pitt B.
      • Filippatos G
      • Agarwal R
      • Anker SD
      • Bakris GL
      • Rossing P
      • et al.
      Cardiovascular events with finerenone in kidney disease and type 2 diabetes.
      Given the miserably poor uptake of even highly beneficial therapies, the obvious urgency is to identify who might benefit most from the early adoption of such treatments.
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