Identification and management of patients at high-risk for cardiovascular disease in primary prevention

Area of Science:

• Cardiology
• Preventive Medicine
• Public Health

Background:

• Atherosclerotic cardiovascular disease (ASCVD) presents a spectrum from subclinical plaque to acute events.
• Traditional primary and secondary prevention strategies may be insufficient for many patients.
• Emerging research emphasizes managing subclinical atherosclerosis to reduce ASCVD risk.

Purpose of the Study:

• To define the
• high-risk primary prevention
• patient with subclinical atherosclerosis and risk factors.
• To review biomarkers and clinical trials for identifying and managing this patient group.
• To discuss current and future therapeutic strategies for lifelong ASCVD risk mitigation.

Main Methods:

• Literature review of biomarker, imaging, and pharmacotherapy trials.
• Analysis of data guiding the management of high-risk primary prevention patients.
• Synthesis of current evidence and future research directions.

Main Results:

• Subclinical atherosclerosis combined with risk factors defines a "high-risk primary prevention" cohort.
• Biomarkers and imaging play a key role in identifying these at-risk individuals.
• Optimal lifelong management strategies are essential for preventing ASCVD progression and events.

Conclusions:

• A paradigm shift towards recognizing "high-risk primary prevention" is necessary.
• Early identification and intervention in patients with subclinical atherosclerosis can significantly reduce ASCVD burden.
• Personalized, long-term therapeutic approaches are vital for optimal patient outcomes.