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Incorporating Risk Stratification Into the Practice of Pediatric Preventive Cardiology
Michael Khoury1, Rae-Ellen W Kavey2, Julie St Pierre3
1Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
The Canadian Journal of Cardiology
|July 18, 2020
Summary
Early cardiovascular disease (CVD) risk factors in children accelerate atherosclerosis. Identifying and managing these risk factors is crucial for preventing premature CVD in pediatric patients.
Area of Science:
- Pediatric Cardiology
- Preventive Cardiology
- Cardiovascular Disease Research
Background:
- Atherosclerosis in early stages shares traditional cardiovascular disease (CVD) risk factors with adult manifest CVD.
- Clustering of risk factors significantly increases atherosclerotic burden from a young age.
- Pediatric medical conditions like chronic kidney disease, obesity, cardiometabolic syndrome, and Kawasaki disease contribute to accelerated atherosclerosis and premature CVD.
Purpose of the Study:
- To emphasize the critical importance of evaluating the comprehensive risk factor and risk-condition profile in pediatric patients.
- To present an algorithm for stratifying pediatric patients into high-, moderate-, and at-risk categories for CVD.
- To provide practical examples of intensified management strategies for individual risk factors in the context of multiple co-existing conditions.
Main Methods:
- Review of existing literature on pediatric atherosclerosis and CVD risk factors.
- Development of a risk stratification algorithm for pediatric patients.
- Illustrative examples of risk factor management intensification based on patient profiles.
Main Results:
- Pediatric risk factors and conditions can lead to accelerated atherosclerosis and increase the likelihood of premature CVD.
- A risk stratification algorithm aids in categorizing pediatric patients based on their overall risk profile.
- Management strategies require adjustment based on the presence of multiple risk factors or conditions, such as modifying LDL cholesterol targets in familial hypercholesterolemia.
Conclusions:
- Comprehensive assessment of pediatric patients' total risk factor and risk-condition profile is essential for effective preventive cardiology.
- Risk stratification and tailored management are key to addressing accelerated atherosclerosis in children.
- Ongoing awareness and identification of emerging risk factors are vital for the practice of pediatric preventive cardiology.
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