The appropriate use of risk scores.

Risk prediction for cardiovascular events has gained popularity in patients undergoing percutaneous coronary intervention (PCI). Methods of estimating the risk of various cardiovascular disease outcomes at different time periods following a variety of interventions using risk score sheets are available now on the Internet. Yet, the desire to predict the future using these scores has begun to impact clinical practice in selection of patients and treatment modalities. When choosing the appropriate risk prediction model, one should take into account the population of interest, risk factors, treatment, procedure to be performed, and the time frame in relation to the cardiovascular outcome. Historically, cardiovascular risk scoring systems were designed to estimate the probability that a person would develop cardiovascular disease within the next 5 or 10 years (1). Because these systems provide an indication of those most likely to develop cardiovascular disease, they also indicate those most likely to benefit from prevention or treatment. In the past, such cardiovascular risk scores acted as tools to help determine who should be offered preventive drugs to lower blood pressure or cholesterol levels.