Improving diagnostic assessments in the ever-changing landscape of atherosclerosis

Abstract

As our understanding of atherosclerotic vascular injury continues to evolve, so should our diagnostic approaches. Emerging data have recently challenged our basic understanding in linking ischemia to its adverse outcomes as well as the need for invasive testing for both diagnosis and treatment. The advent of coronary computed tomography in providing improved visualization of coronary arteries has led to the identification of both subclinical atherosclerosis and high-risk coronary lesions. Recognition of asymptomatic coronary artery disease (CAD) with objective localization of subclinical coronary atherosclerosis improves atherosclerotic cardiovascular risk assessment and allows healthcare providers to take effective primary prevention measures. Therefore, reshaping the diagnostic landscape in proposing new testing modalities would be highly dependent on local resource availability and the reading expertise of each clinical practice and medical institution. The main objective of this Review is to propose a potentially new diagnostic approach of simply using noninvasive stress testing or coronary angiography in the routine assessment of CAD.

Positive association between alkaline phosphatase and arteriosclerosis: a cross-sectional study

“…Considering the burden of cardiovascular disease, it is important to identify individuals with subclinical atherosclerosis, before plaque progression leads to acute coronary syndrome (ACS) or sudden cardiac death (SCD), through having a personalized atherosclerotic phenotypic approach. Over classical risk factors, some ‘enhancing factors’ such as comorbidities and noninvasive diagnostic tests (arteriosclerosis, artery calcification, intima–media thickness or plaques at carotid or peripheral artery ultrasound) may be considered 2 . The present study used arteriosclerosis as an important indicator to identify subclinical atherosclerosis.…”