Sophisticated tests for susceptibility to atherosclerosis: an added value for heart hospitals

Coronary atherosclerosis is the result of multiple complex metabolic disorders acting alone or in combination. Metabolic cardiology has advanced considerably in the past decade and now offers cardiologists a sophisticated approach to treating the underlying cause(s) of coronary artery disease in patients seen in invasive cardiology practices. Disorders which have now been powerfully linked to coronary artery disease include the small low-density lipoprotein trait, impaired reverse cholesterol transport, homocysteinemia, insulin resistance, aspects of inflammation, and infectious burden. These disorders are common and alone, or in combination, are found in over 90% of patients with coronary artery disease. Treatments for these disorders are well elucidated and have been associated with cardiovascular benefit. Incorporation of a sophisticated metabolic atherosclerosis management unit into existing invasive cardiology practices offers the cardiologist and patient many benefits. The cardiologist obtains a powerful tool that complements invasive cardiology, provides patients with access to cutting-edge diagnosis and treatment, and provides a forum that allows incorporation of clinically valid advances in metabolic cardiovascular care in a time frame far shorter than the traditional consensus recommendation approach. Incorporation of such a clinical service is consistent with the recent American College of Cardiology focus on the "CardioTeam."