From the Michael E. DeBakey Veterans Affairs Hospital, Baylor College of Medicine, Houston, Texas; and the Heart and Vascular Center, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts. Dr. Nambi has a provisional patent along with Baylor College of Medicine and Roche entitled “Use of biomarkers in prediction of heart failure”; has served as an event adjudicator for Siemens Diagnostics; and has served as a site principal investigator for Merck. Dr. Bhatt has served on the advisory boards of Cardax, Elsevier Practice Update Cardiology, Medscape Cardiology, and Regado Biosciences; has served on the board of directors of Boston VA Research Institute and the Society of Cardiovascular Patient Care; has served as chair of the American Heart Association Quality Oversight Committee, NCDR-ACTION Registry Steering Committee, and VA CART Research and Publications Committee; has served on data monitoring committees for Cleveland Clinic, Duke Clinical Research Institute, Harvard Clinical Research Institute, Mayo Clinic, Mount Sinai School of Medicine, and Population Health Research Institute; has received honoraria from the American College of Cardiology (senior associate editor, Clinical Trials and News, ACC.org), Belvoir Publications (Editorin-Chief, Harvard Heart Letter), Duke Clinical Research Institute (clinical trial steering committees), Harvard Clinical Research Institute (clinical trial steering committee), HMP Communications (Editor-in-Chief, Journal of Invasive Cardiology), Journal of the American College of Cardiology (guest editor, associate editor), Population Health Research Institute (clinical trial steering committee), Slack Publications (chief medical editor, Cardiology Today’s Intervention), Society of Cardiovascular Patient Care (secretary/ treasurer), and WebMD (CME steering committees); has served as deputy editor of Clinical Cardiology; has received research funding from Amarin, Amgen, AstraZeneca, Bristol-Myers Squibb, Chiesi, Eisai, Ethicon, Forest Laboratories, Ironwood, Ischemix, Lilly, Medtronic, Pfizer, Roche, Sanofi, and The Medicines Company; has received royalties from Elsevier (editor, Cardiovascular Intervention: A Companion to Braunwald’s Heart Disease); has served as site co-investigator for Biotronik, Boston Scientific, and St. Jude Medical (now Abbott); has served as a trustee for the American College of Cardiology; and has performed unfunded research for FlowCo, Merck, PLx Pharma, and Takeda. health. However, what is normal (1,2)? Although guidelines may identify particular levels as “abnormal,” dichotomizing continuous variables is always somewhat arbitrary. The expert panels that write guidelines or develop risk scores are clearly familiar with this conundrum, yet due to human fascination with goals and targets, they provide cutpoints. On occasions when they have not, there has been intense debate.

中文翻译：

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动脉粥样硬化的一级预防

来自德克萨斯州休斯顿贝勒医学院 Michael E. DeBakey 退伍军人事务医院；以及马萨诸塞州波士顿哈佛医学院布莱根妇女医院心脏和血管中心。Nambi 博士与贝勒医学院和罗氏一起拥有一项临时专利，题为“使用生物标志物预测心力衰竭”；曾担任西门子诊断的事件裁决员；并曾担任默克公司的现场首席研究员。Bhatt 博士曾在 Cardax、Elsevier Practice Update Cardiology、Medscape Cardiology 和 Regado Biosciences 的顾问委员会任职；曾在波士顿 VA 研究所和心血管患者护理协会的董事会任职；曾担任美国心脏协会质量监督委员会、NCDR-ACTION 注册指导委员会主席，和 VA CART 研究和出版委员会；曾在克利夫兰诊所、杜克临床研究所、哈佛临床研究所、梅奥诊所、​​西奈山医学院和人口健康研究所的数据监测委员会任职；曾获得美国心脏病学会（高级副主编，临床试验和新闻，ACC.org）、Belvoir Publications（主编，Harvard Heart Letter）、杜克临床研究所（临床试验指导委员会）、哈佛临床研究的酬金Institute（临床试验指导委员会）、HMP Communications（Journal of Invasive Cardiology）、Journal of the American College of Cardiology（客座主编、副主编）、Population Health Research Institute（临床试验指导委员会）、Slack Publications（首席医学编辑，Cardiology Today's Intervention）、心血管患者护理协会（秘书/财务主管）和 WebMD（CME 指导委员会）；曾任Clinical Cardiology副主编；获得了 Amarin、Amgen、AstraZeneca、Bristol-Myers Squibb、Chiesi、Eisai、Ethicon、Forest Laboratories、Ironwood、Ischemix、Lilly、Medtronic、Pfizer、Roche、Sanofi 和 The Medicines Company 的研究资助；已从爱思唯尔（编辑，心血管干预：布劳恩瓦尔德心脏病的伴侣）获得版税；曾担任 Biotronik、Boston Scientific 和 St. Jude Medical（现为 Abbott）的现场联合调查员；曾担任美国心脏病学会的受托人；并为 FlowCo、默克、PLx Pharma 和武田进行了无资助的研究。健康。然而，什么是正常的 (1, 2）？尽管指南可能会将特定水平识别为“异常”，但将连续变量二分化总是有些武断。编写指南或制定风险评分的专家小组显然熟悉这个难题，但由于人类对目标和指标的迷恋，他们提供了切入点。有时，当他们没有这样做时，就会发生激烈的辩论。