Publication details

Advancements in risk stratification and management strategies in primary cardiovascular prevention

Authors	BARKAS Fotios SENER Yusuf Ziya GOLFOROUSH Pelin Arabacilar KHEIRKHAH Azin RODRIGUEZ-SANCHEZ Elena NOVÁK Jan APELLANIZ-RUIZ Maria AKYEA Ralph Kwame BIANCONI Vanessa CEASOVSCHIH Alexandr CHEE Ying Jie CHERSKA Mariia CHORA Joana Rita ORIA Mario DEMIKHOVA Nadiia BURUNKAYA Duygu Kocyigit RIMBERT Antoine MACCHI Chiara RATHOD Krishnaraj ROTH Lynn SUKHORUKOV Vasily STOICA Svetlana SCICALI Roberto STOROZHENKO Tatyana UZOKOV Jamol LUPO Maria Giovanna VAN DER VORST Emiel P C PORSCH Florentina
Year of publication	2024
Type	Article in Periodical
Magazine / Source	Atherosclerosis
MU Faculty or unit	Faculty of Medicine
Citation
Web	https://www.sciencedirect.com/science/article/pii/S0021915024001394?via%3Dihub
Doi	http://dx.doi.org/10.1016/j.atherosclerosis.2024.117579
Keywords	Cardiovascular disease; Atherosclerosis; Risk stratification; Plaque regression; Primary prevention
Description	Atherosclerotic cardiovascular disease (ASCVD) remains a leading cause of morbidity and mortality worldwide, highlighting the urgent need for advancements in risk assessment and management strategies. Although significant progress has been made recently, identifying and managing apparently healthy individuals at a higher risk of developing atherosclerosis and those with subclinical atherosclerosis still poses significant challenges. Traditional risk assessment tools have limitations in accurately predicting future events and fail to encompass the complexity of the atherosclerosis trajectory. In this review, we describe novel approaches in biomarkers, genetics, advanced imaging techniques, and artificial intelligence that have emerged to address this gap. Moreover, polygenic risk scores and imaging modalities such as coronary artery calcium scoring, and coronary computed tomography angiography offer promising avenues for enhancing primary cardiovascular risk stratification and personalised intervention strategies. On the other hand, interventions aiming against atherosclerosis development or promoting plaque regression have gained attention in primary ASCVD prevention. Therefore, the potential role of drugs like statins, ezetimibe, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, omega -3 fatty acids, antihypertensive agents, as well as glucose -lowering and anti-inflammatory drugs are also discussed. Since findings regarding the efficacy of these interventions vary, further research is still required to elucidate their mechanisms of action, optimize treatment regimens, and determine their long-term effects on ASCVD outcomes. In conclusion, advancements in strategies addressing atherosclerosis prevention and plaque regression present promising avenues for enhancing primary ASCVD prevention through personalised approaches tailored to individual risk profiles. Nevertheless, ongoing research efforts are imperative to refine these strategies further and maximise their effectiveness in safeguarding cardiovascular health.