BaleDoneen: white paper on the MESA trial results

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BaleDoneen Discussion of:

Yeboah, J, McClelland RL, Polonsky TS, et al.  Comparison of novel risk markers for improvement in cardiovascular risk assessment in intermediate-risk individuals. JAMA 8.21.2012; 308: 788-795.

MESA data: 1,330 non-diabetics, intermediate risk individuals followed for approximately 7.6 years.

Comparison was performed between CACS, CIMT, ABI, brachial FMD, hsCRP, and family history to enhance the Framingham score for predicting Cardiovascular Events.

There were a total of 123 CVD events (94 CHD).

Results:

Independent significant predictors:

CAC:    HR-2.60 (95% CI, 1.94-3.50)
Famhx: HR-2.18 (95% CI, 1.38-3.42)
hsCRP: HR-1.28 (95% CI, 1.00-1.64)
ABI:      HR-0.79 (95% CI, 0.66-0.95)

Non-significant independent predictors:

CIMT:    HR-1.17 (95% CI, 0.95-1.45)
BFMD:  HR-0.95 (95% CI, 0.78-1.14)

CACS provided superior discrimination and risk reclassification compared with other markers in this trial.

The BaleDoneen Method stands strong upon a disease treatment paradigm that measures risk through an inflammatory lens.  It is paramount that we assess each patient for the presence or absence of an atheroma.  We agree with these trial results and celebrate the findings.

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