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The first SHAPE (Screening for Heart Attack Prevention and Education) guideline
Morteza Naghavi1, Erling Falk, Harvey S Hecht
1Association for Eradication of Heart Attack, Houston, Texas 77005, USA. mn2@vp.org
Critical Pathways in Cardiology
|March 15, 2008
Summary
Early detection of subclinical atherosclerosis through noninvasive screening can prevent atherosclerotic cardiovascular disease (A-CVD). The SHAPE Guideline recommends screening for vulnerable asymptomatic individuals to improve primary prevention and reduce heart attack and stroke risks.
Area of Science:
- Cardiology and Preventive Medicine
- Medical Imaging and Diagnostics
Background:
- Atherosclerotic cardiovascular disease (A-CVD) is the leading global cause of death and disability.
- Current A-CVD risk factor-based guidelines inadequately identify high-risk asymptomatic individuals.
- The growing burden of A-CVD, especially in developing nations, necessitates improved prevention strategies.
Purpose of the Study:
- To introduce the First SHAPE Guideline for primary prevention of A-CVD.
- To address the shortcomings of traditional risk factor assessment in identifying vulnerable patients.
- To advocate for early detection of subclinical atherosclerosis in asymptomatic individuals.
Main Methods:
- Proposed noninvasive screening for asymptomatic men aged 45-75 and women aged 55-75.
- Utilizes the SHAPE Flow Chart, incorporating coronary artery calcium scoring (CT) and carotid intima-media thickness/plaque (ultrasound).
- Emphasizes individualized risk assessment based on direct detection of atherosclerosis.
Main Results:
- Detecting subclinical atherosclerosis demonstrates superior prognostic value over traditional risk factors.
- The SHAPE Guideline aims to identify and treat individuals with subclinical atherosclerosis missed by current methods.
- Treatment intensity should correlate with the detected severity of subclinical atherosclerosis.
Conclusions:
- Early, noninvasive detection of subclinical atherosclerosis is a crucial, achievable step in A-CVD primary prevention.
- The SHAPE Guideline offers a more effective approach to identifying and managing high-risk asymptomatic individuals.
- Implementing SHAPE recommendations can potentially reduce the incidence of heart attacks and strokes globally.
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