May subclinical arterial disease help to better detect and treat high-risk asymptomatic individuals?

Area of Science:

• Cardiology
• Vascular Medicine
• Preventive Cardiology

Background:

• Traditional risk factors and scoring systems improve cardiovascular disease (CVD) risk diagnosis in asymptomatic individuals.
• Novel measures are needed to enhance the detection of high-risk individuals, potentially replacing or supplementing traditional factors.
• Subclinical arterial disease detection is a promising area for improving CVD risk evaluation.

Purpose of the Study:

• To explore the potential of non-invasive subclinical arterial disease detection for refining CVD risk assessment.
• To evaluate if identifying subclinical disease can guide more intensive risk-reduction therapies in intermediate-risk patients.
• To address the current uncertainty regarding the clinical utility and cost-effectiveness of strategies guided by subclinical arterial disease.

Main Methods:

• Review of current risk assessment strategies for cardiovascular disease (CVD).
• Discussion of emerging non-invasive methods for detecting subclinical arterial disease.
• Analysis of the potential impact of subclinical disease detection on risk stratification and treatment.

Main Results:

• While traditional risk factors improve CVD risk diagnosis, they have limitations.
• Non-invasive subclinical arterial disease detection shows potential for enhanced risk evaluation.
• The clinical utility and cost-effectiveness of using subclinical disease for guiding therapy remain unproven.

Conclusions:

• Subclinical arterial disease detection may enhance CVD risk assessment and personalize treatment for intermediate-risk individuals.
• Current evidence does not support routine, systematic screening for subclinical arterial disease in primary prevention.
• Physician discretion may allow for its use as part of a comprehensive CVD risk assessment.