Assessment of cardiovascular disease risk: a 2023 update

Abstract

Purpose of review The aim of this study was to highlight the current best practice for atherosclerotic cardiovascular disease (CVD) risk evaluation, including selective use of adjunctive tools for risk stratification [e.g. coronary artery calcium (CAC) scoring] and risk enhancement [e.g. lipoprotein(a) [Lp(a)], polygenic risk scoring (PRS)]. Recent findings New studies have evaluated the efficacy of various risk assessment tools. These studies demonstrate the role of Lp(a) as a risk-enhancing factor ready for more widespread use. CAC is the gold standard method of assessing subclinical atherosclerosis, enabling true risk stratification of patients, and informing net benefit assessment for initiating or titrating lipid-lowering therapy (LLT). Summary Lp(a) concentration and CAC scoring, apart from the traditional risk factors, add the most value to the current CVD risk assessment approaches of all available tools, especially in terms of guiding LLT. In addition to new integrative tools such as the MESA CHD Risk Score and Coronary Age calculator, the future of risk assessment may include PRS and more advanced imaging techniques for atherosclerosis burden. Soon, polygenic risk scoring may be used to identify the age at which to begin CAC scoring, with CAC scores guiding preventive strategies.

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“…6,7 Current data suggest that the prevalence of CVDs will increase further in the near future. 8 Common contributors to CVDs include various environmental factors such as air pollution and environmental noise, as well as unhealthy lifestyle factors such as smoking 9 and excessive alcohol consumption. 10 In addition, cardiotoxicity induced by drugs often leads to cardiac dysfunction and even sudden death.…”

“…The proper functioning of the cardiovascular system, including the heart, blood vessels, and blood, plays a pivotal role in maintaining human physiological well-being, since malfunctions in cardiovascular function generally pose significant health challenges. Notably, cardiovascular diseases (CVDs) are the greatest cause of global morbidity and mortality. − The global prevalence of CVDs has almost doubled in the past two decades, killing approximately 17.9 million people each year. , Current data suggest that the prevalence of CVDs will increase further in the near future . Common contributors to CVDs include various environmental factors such as air pollution and environmental noise, as well as unhealthy lifestyle factors such as smoking and excessive alcohol consumption .…”