Risk stratification in cardiovascular disease primary prevention - scoring systems, novel markers, and imaging...

Area of Science:

• Cardiology
• Preventive Medicine
• Biomarkers and Imaging

Background:

• Classical risk factors (blood pressure, LDL cholesterol) are central to cardiovascular disease (CVD) risk estimation.
• Current risk assessment methods have limitations including variable treatment thresholds, imprecise measurements, and residual risk.
• Emerging biomarkers and imaging techniques offer potential advancements in CVD risk stratification.

Purpose of the Study:

• To review and discuss current cardiovascular disease (CVD) risk stratification methods.
• To evaluate emerging biomarkers and imaging techniques for CVD prevention.
• To assess the relative merits and limitations of various risk assessment approaches.

Main Methods:

• Expert discussions from a European Society of Cardiology workshop.
• Review of classical risk factors (blood pressure, LDL cholesterol).
• Evaluation of novel risk markers (e.g., C-reactive protein, genetic markers) and imaging techniques (e.g., ultrasound, MRI).

Main Results:

• Classical risk factors remain foundational but have limitations in guiding management.
• Novel markers like C-reactive protein and lipoprotein-associated phospholipase A(2) have varying levels of evidence.
• Imaging techniques like high-resolution ultrasound and MRI show potential but require further validation for general population use.

Conclusions:

• Classical risk scoring systems are accessible and affordable but possess inherent limitations.
• Novel risk markers and imaging techniques may be valuable in drug development and clinical trials.
• The added clinical utility of novel markers and imaging beyond classical factors for risk-guided CVD prevention requires further determination.