0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Letters |

Cardiovascular Disease Risk Prediction Factors

Allan D. Sniderman, MD, FRSC; Curt D. Furberg, MD, PhD
JAMA. 2012;308(19):1969. doi:10.1001/jama.2012.14049.
Text Size: A A A
Published online

Extract

To the Editor: The Emerging Risk Factors Collaboration1 (ERFC) reported on the addition of lipid-related markers to total cholesterol and high-density lipoprotein cholesterol (HDL-C) in the prediction of cardiovascular disease. We attempted to replicate the findings of eTable 1, which summarized the 26 studies that compared apolipoprotein B with the cholesterol markers.

Many discrepancies with the primary publications were found. First, 4 eligible studies, including the Framingham Offspring Study,2 were not included. Second, 5 studies did not meet the entry criteria, which included approved definitions and recording of both fatal and nonfatal cardiovascular events. The Whitehall I study3 recorded only fatal ischemic heart disease and so should not have been eligible. Yet strokes were listed in eTable 1 even though they were not a protocol outcome. Third, in 19 of the 26 studies, the number of participants differed substantially between eTable 1 and the primary publication. In 14 studies, there were fewer participants whereas in 5 studies, there were more participants. For example, the ERFC study listed 1293 patients for the Quebec Cardiovascular Study vs the actual tally of 2072.4 The ERFC study listed 23 175 for the Women's Health Study vs 15 632 in the primary report.5 Fourth, the values for apolipoprotein B in 4 study reports differed substantially from those given by the ERFC and neither the methods to measure apolipoprotein B nor the results were given in 4 other studies. Furthermore, in at least 2 studies, apolipoprotein B was measured many years after collection with no documentation of adequate sample preservation. Fifth, the methods and results of 11 studies have not been recorded in the public domain.

Topics

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Letters

November 21, 2012
Ken Williams, PStat; Howard M. Monroe, PhD
JAMA. 2012;308(19):1969. doi:10.1001/jama.2012.14042.
November 21, 2012
Emanuele Di Angelantonio, MD, PhD; Pei Gao, PhD; John Danesh, FRCP; for the Emerging Risk Factors Collaboration
JAMA. 2012;308(19):1969. doi:10.1001/jama.2012.14045.
CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 1

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Jobs
brightcove.createExperiences();