Risk prediction and prevention in patients with advanced subclinical atherosclerosis

Area of Science:

• Cardiology
• Preventive Medicine
• Medical Imaging

Background:

• Cardiovascular diseases (CVD) are the leading global cause of mortality.
• Current risk stratification tools for CVD have limitations in early detection.
• There's a need for advanced methods to identify patients at risk for CVD.

Purpose of the Study:

• To address limitations of conventional CVD risk factors.
• To evaluate imaging techniques for early CVD detection.
• To assess personalized aspirin therapy for advanced subclinical atherosclerosis.

Main Methods:

• Expert literature review and medical advisory board meeting outcomes from the Middle East.
• Discussion on the cardiac risk continuum and advanced subclinical atherosclerosis detection.
• Evaluation of carotid ultrasound and coronary artery calcium (CAC) scoring feasibility and aspirin's role in primary prevention.

Main Results:

• Tailored risk assessment and individualized preventive measures are necessary.
• CAC scoring and carotid ultrasound are practical for identifying at-risk patients and quantifying subclinical atherosclerosis.
• Aspirin's preventive benefit increases with atherosclerosis burden, showing a net positive at CAC > 100 or carotid plaque score > 2.

Conclusions:

• Individualized screening strategies are crucial for the Middle Eastern population.
• Selective use of CAC and carotid ultrasound can improve CVD risk stratification and personalize management.
• Standardized protocols, education, and infrastructure development are needed for effective implementation.