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Screening for coronary artery disease in asymptomatic individuals: Why and how?

Philippe Degrell1, Emmanuel Sorbets1, Laurent J Feldman1

  • 1Département hospitalo-universitaire fibrose, inflammation, remodelage (FIRE), French Alliance for Cardiovascular clinical Trials (FACT) and F-CRIN network, université Paris-Diderot, Sorbonne Paris Cité, Paris, France; Hôpital Bichat and hôpital Avicenne, Assistance publique-Hôpitaux de Paris, hôpitaux universitaires Paris Nord Val-de-Seine, Paris, France; Inserm U-1148, Paris, France.

Archives of Cardiovascular Diseases
|November 25, 2015
PubMed

Insights

Screening asymptomatic individuals for coronary artery disease (CAD) is crucial for preventive treatment. Coronary artery calcium scoring shows the most promise for identifying intermediate-risk individuals.

Area of Science:

  • Cardiology
  • Preventive Medicine
  • Biomarkers and Imaging

Background:

  • Cardiovascular disease remains the leading global cause of mortality, with coronary artery disease as the primary contributor.
  • Preventive strategies for asymptomatic individuals are of significant clinical interest.

Purpose of the Study:

  • To evaluate the added value of novel biomarkers and imaging techniques for screening asymptomatic individuals for coronary artery disease.
  • To identify the most effective methods for risk stratification in intermediate-risk populations.

Main Methods:

  • Review of established risk scores (e.g., Framingham, SCORE) and emerging diagnostic tools.
  • Assessment of biomarkers including high-sensitivity C-reactive protein and phospholipase A2 variants.
  • Evaluation of imaging modalities such as coronary artery calcium score, carotid intima-media thickness, and ankle-brachial index.

Main Results:

  • The added value of new biomarkers and imaging methods over traditional risk scores varies.
  • Coronary artery calcium scoring demonstrates the most convincing evidence for improving risk assessment.
  • This method is particularly beneficial for asymptomatic individuals classified as intermediate-risk.

Conclusions:

  • Coronary artery calcium scoring is a valuable tool for refining risk assessment in asymptomatic individuals.
  • It aids in identifying those who may benefit from early preventive interventions for coronary artery disease.
  • Further research may elucidate the roles of other emerging markers in cardiovascular risk stratification.

Keywords:
Cardiovascular riskCoronary artery calcium scoreCoronary artery diseaseDépistageMaladie coronairePreventionPréventionRisque cardiovasculaireScore calciqueScreening

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