Tracking atherosclerosis regression: a clinical tool in preventive cardiology

Area of Science:

• Cardiovascular Medicine
• Medical Imaging
• Preventive Cardiology

Background:

• Coronary artery disease (CAD) progression was historically assessed by quantitative coronary angiography, linked to adverse cardiovascular outcomes.
• Emerging atherosclerosis imaging techniques provide new tools for evaluating preventive therapies by monitoring atherosclerosis burden.
• Large randomized trials for medical management of atherosclerosis are often impractical due to cost and resource constraints.

Purpose of the Study:

• To review the application of advanced atherosclerosis imaging modalities in cardiovascular prevention.
• To highlight their role as emerging tools for assessing therapeutic effectiveness and as surrogate endpoints in clinical trials.

Main Methods:

• Review of current literature on atherosclerosis imaging modalities.
• Focus on coronary computed tomography, carotid ultrasound, cardiovascular magnetic resonance imaging, and intravascular ultrasound.
• Evaluation of their capabilities for serial monitoring and use as intermediate endpoints.

Main Results:

• Atherosclerosis imaging modalities offer serial monitoring of atherosclerosis burden.
• These techniques serve as surrogate endpoints with substantial outcome relevance.
• They are increasingly used in clinical trials and individual patient management.

Conclusions:

• Advanced imaging techniques are valuable tools in cardiovascular prevention.
• They enable efficient evaluation of preventive therapies and facilitate clinical trial design.
• These modalities are transforming the management of atherosclerosis by providing objective measures of disease burden and treatment response.