Between risk charts and imaging: how should we stratify cardiovascular risk in clinical practice?

Area of Science:

• Cardiology
• Preventive Medicine
• Medical Imaging

Background:

• Cardiovascular (CV) risk prediction is crucial for primary prevention.
• Existing risk charts have limitations and are underutilized in clinical practice.
• Novel risk markers have not significantly improved the discriminative power of these charts.

Purpose of the Study:

• To evaluate the role of advanced imaging in cardiovascular risk stratification.
• To explore how imaging can overcome limitations of conventional risk prediction charts.

Main Methods:

• Review of current literature on cardiovascular risk prediction and stratification.
• Analysis of the potential of non-invasive imaging techniques for detecting subclinical atherosclerosis.
• Comparison of imaging-based risk assessment with traditional risk charts.

Main Results:

• Conventional risk charts have significant limitations and are underutilized.
• Novel risk markers have failed to substantially improve risk chart performance.
• Non-invasive imaging can detect subclinical atherosclerosis, offering insights into preclinical disease.
• Imaging may provide a more accurate risk assessment than current charts.

Conclusions:

• Advanced imaging techniques show promise for improving cardiovascular risk stratification.
• Detecting preclinical atherosclerosis via imaging could enhance primary CV prevention strategies.
• Further integration of imaging into clinical practice may overcome limitations of current risk prediction tools.