Contemporary Review of Risk Scores in Prediction of Coronary and Cardiovascular Deaths.

Accurate risk prediction remains the foundation of management choice in primary prevention. When applied to new populations, the calibration of a predictive model will deteriorate, although discrimination changes minimally. One of the approaches with better performance and validation is the initial use of pooled cohort equation to identify low and high-risk patients, followed by coronary artery calcium scoring in those with borderline to intermediate risk. It is important to utilize a risk stratification tool that has been validated in a patient population that resembles the one used to develop the original tool to maintain adequate calibration. It is likely that the future of mortality risk prediction will develop in combined clinical risk predictors and cardiovascular imaging, such coronary artery calcium (CAC) scoring that renders the highest predictive accuracy.