Personalizing Treatment: Between Primary and Secondary Prevention.

Area of Science:

• Cardiology
• Preventive Medicine
• Medical Diagnostics

Background:

• Current guidelines emphasize atherosclerotic cardiovascular disease (ASCVD) risk assessment for initiating cholesterol pharmacotherapy.
• Treatment decisions rely on traditional risk factors, with advanced testing for uncertain or intermediate-risk cases.
• New guidelines promote shared decision-making between clinicians and patients regarding treatment benefits and risks.

Purpose of the Study:

• To evaluate the role and efficacy of advanced risk testing in ASCVD risk stratification.
• To compare the predictive power of different advanced risk testing modalities.
• To identify optimal strategies for managing patients with elevated cholesterol and intermediate ASCVD risk.

Main Methods:

• Review of current American College of Cardiology/American Heart Association guidelines.
• Analysis of traditional cardiovascular risk factors used in risk calculators.
• Evaluation of comparative efficacy studies for advanced risk testing options.

Main Results:

• Coronary artery calcium scoring demonstrates the strongest predictive value for ASCVD events among advanced tests.
• Advanced risk testing is increasingly important with new therapies and guideline updates.
• Coronary artery calcium scoring identifies subclinical atherosclerosis, aiding treatment decisions for intermediate-risk patients.

Conclusions:

• Coronary artery calcium scoring is a highly effective tool for ASCVD risk assessment.
• This advanced testing method can guide more personalized and aggressive lipid-lowering therapy.
• Integrating advanced risk testing enhances clinician-patient risk discussions and treatment decisions.