Abstract for: Improving the primary prevention of coronary artery disease in Australia: modelling the effect of a novel predictor

As in other countries, the incidence of coronary artery disease has been declining rapidly in Australia for several decades, and yet it remains the leading single cause of death here.  One way of continuing the downward trend would be to improve the early identification of those at elevated risk of developing CAD later in life, so that they could make changes to reduce their risk.  An exciting recent development has been the discovery of predictors of CAD that are orthogonal to the factors traditionally used to assess the level of risk, and which therefore have the potential to identify a whole sub-population of at-risk people who are not captured by current routine assessments.  We have adapted an existing system dynamics (SD) model of the evolution of traditional CAD risk factors and their effect on CAD incidence and mortality, to let us evaluate the potential impact of incorporating these novel predictors into the country’s primary prevention systems.  We are using the new model to explore a wide range of scenarios, both for the uptake of the novel risk assessment by practitioners and for the adoption of, and adherence to, mitigation strategies by people found to be at high risk.  Health economic, as well as public health, implications of using the new measure are being studied.