Cardiovascular Risk Assessment & Management Flashcards

In the Reynolds Risk Score, which additional biomarker is incorporated compared to the Framingham Risk Score?

Answer: High-sensitivity CRP (hsCRP) and family history of premature MI

The Reynolds Risk Score adds hsCRP and parental history of premature MI to traditional Framingham variables for improved risk discrimination.

Which statement about the ankle-brachial index (ABI) as a cardiovascular risk marker is correct?

Answer: An ABI <0.9 is diagnostic of peripheral artery disease and signals elevated ASCVD risk

An ABI <0.9 indicates peripheral artery disease, which is an ASCVD risk equivalent that increases overall cardiovascular event risk.

A 45-year-old woman is classified as intermediate ASCVD risk. Her hsCRP is 4.2 mg/L. According to JUPITER trial evidence, statin therapy is most likely to benefit patients with which profile?

Answer: Normal LDL-C (<100 mg/dL) and hsCRP ≥2 mg/L

The JUPITER trial showed rosuvastatin reduced cardiovascular events in patients with normal LDL-C (<130 mg/dL) but elevated hsCRP (≥2 mg/L).

Which cardiovascular risk factor is best addressed by assessing urine albumin-to-creatinine ratio (UACR) in a hypertensive diabetic patient?

Answer: Detecting early chronic kidney disease as an ASCVD risk enhancer

Microalbuminuria (UACR 30–300 mg/g) signals early CKD, which is an independent ASCVD risk enhancer beyond traditional risk factors.

In secondary prevention, the 2018 ACC/AHA guidelines define 'very high-risk ASCVD' patients as those with major ASCVD events plus which additional criteria?

Answer: Major ASCVD events plus high-risk conditions such as multiple events or diabetes

Very high-risk ASCVD is defined by multiple major ASCVD events or one major event plus high-risk conditions (e.g., diabetes, CKD, familial hypercholesterolemia, smoking).

A non-HDL-C goal is particularly useful compared to LDL-C alone in patients with:

Answer: Hypertriglyceridemia, where VLDL-C contribution is significant

Non-HDL-C captures all atherogenic lipoproteins including VLDL-C, making it more informative than LDL-C in hypertriglyceridemic states.

What is the primary mechanism by which metabolic syndrome increases cardiovascular risk beyond individual risk factors?

Answer: Clustering of insulin resistance, dyslipidemia, hypertension, and central obesity causing additive risk

Metabolic syndrome's risk stems from clustering of multiple interrelated abnormalities driven by insulin resistance, which additively amplifies ASCVD risk.