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Quantitative Analysis of Cellular Composition in Advanced Atherosclerotic Lesions of Smooth Muscle Cell Lineage-Tracing Mice
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Advanced subclinical atherosclerosis: A novel category within the cardiovascular risk continuum with distinct

Michael J Blaha1, Magdy Abdelhamid2, Francesca Santilli3

  • 1Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Blalock 524D1, 600 N. Wolfe Street, Baltimore, MD 21287, USA.

American Journal of Preventive Cardiology
|January 12, 2023
PubMed

Insights

Guidelines for atherosclerotic cardiovascular disease (ASCVD) risk management need updating. A new "advanced subclinical atherosclerosis" group bridges primary and secondary prevention, improving risk stratification and therapy matching.

Area of Science:

  • Cardiology
  • Preventive Medicine
  • Medical Imaging

Background:

  • Current guidelines categorize atherosclerotic cardiovascular disease (ASCVD) risk management into primary and secondary prevention.
  • This binary approach conflicts with the continuous biological progression of atherosclerosis.
  • Coronary artery calcium (CAC) scoring reveals individuals in primary prevention with risks comparable to secondary prevention subgroups.

Discussion:

  • A new clinical group, "advanced subclinical atherosclerosis," is proposed, situated between traditional primary and secondary prevention categories.
  • This classification aims to align risk assessment with the biological continuum of atherosclerosis.
  • Visualizing plaque burden is key to identifying this intermediate patient population.

Key Insights:

  • A novel graphic is introduced to visualize the "advanced subclinical atherosclerosis" group based on plaque burden.
  • This tool facilitates better identification of individual cardiovascular risk.
  • The graphic supports more effective, risk-based management strategies.

Outlook:

  • The proposed framework and visualization tool can enhance clinical decision-making for ASCVD risk management.
  • Integrating plaque burden assessment may refine therapeutic intensity matching.
  • This approach could lead to more personalized and effective preventive cardiology strategies.

Keywords:
Cardiovascular diseaseCoronary artery calciumEducationPrimary preventionRisk assessmentSubclinical atherosclerosis

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