Secondary prevention strategy of cardiovascular disease using endothelial function testing

Area of Science:

• Cardiovascular Medicine
• Vascular Biology
• Preventive Cardiology

Background:

• Despite advances in cardiovascular disease (CV) secondary prevention, recurrent CV events remain a concern.
• Existing therapies target conventional risk factors but show variable efficacy due to interindividual differences.
• Atherosclerosis progression and complications are linked to endothelial dysfunction, reflecting an individual's overall vascular health.

Purpose of the Study:

• To review the role of endothelial dysfunction in atherosclerotic cardiovascular disease within the secondary prevention context.
• To explore the potential of endothelial function assessment for guiding personalized management strategies.
• To highlight the significance of endothelial function as an active disease marker and predictor of CV events.

Main Methods:

• Literature review focusing on endothelial function in secondary CV prevention.
• Analysis of the relationship between endothelial dysfunction and CV event rates.
• Evaluation of endothelial function as an integrated measure of atherogenic and atheroprotective factors.

Main Results:

• Endothelial function is pivotal throughout atherosclerosis, from initiation to complications.
• Endothelial dysfunction is a significant risk factor for future CV events.
• Improved endothelial function correlates with reduced CV event risk, even in secondary prevention.

Conclusions:

• Endothelial function assessment provides a comprehensive view of vascular health and disease activity.
• An endothelial function-guided strategy may enable tailored, personalized medicine for secondary CV prevention.
• Implementing endothelial function assessment could significantly improve patient outcomes in cardiovascular disease management.