Role of cardiovascular imaging in risk assessment: recent advances, gaps in evidence, and future directions
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Optimal risk assessment for primary prevention remains highly challenging. Recent registries have highlighted major discrepancies between guidelines and daily practice. Although guidelines have improved over time and provide updated risk scores, they still fail to identify a significant proportion of at-risk individuals, who then miss out on effective prevention measures until their initial ischemic events. Cardiovascular imaging is progressively assuming an increasingly pivotal role, playing a crucial part in enhancing the meticulous categorization of individuals according to their risk profiles, thus enabling the customization of precise therapeutic strategies for patients with increased cardiovascular risks. For the most part, the current approach to patients with atherosclerotic cardiovascular disease (ASCVD) is homogeneous. However, data from registries (e.g., REACH, CORONOR) and randomized clinical trials (e.g., COMPASS, FOURIER, and ODYSSEY outcomes) highlight heterogeneity in the risks of recurrent ischemic events, which are especially higher in patients with poly-vascular disease and/or multivessel coronary disease. This indicates the need for a more individualized strategy and further research to improve definitions of individual residual risk, with a view of intensifying treatments in the subgroups with very high residual risk. In this narrative review, we discuss advances in cardiovascular imaging, its current place in the guidelines, the gaps in evidence, and perspectives for primary and secondary prevention to improve risk assessment and therapeutic strategies using cardiovascular imaging.
Date Issued
2023-09-01
Date Acceptance
2023-08-23
Citation
Journal of Clinical Medicine, 2023, 12 (17)
ISSN
2077-0383
Publisher
MDPI AG
Journal / Book Title
Journal of Clinical Medicine
Volume
12
Issue
17
Copyright Statement
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/37685628
PII: jcm12175563
Subjects
cardiovascular imaging
cardiovascular risk
COMPUTED TOMOGRAPHIC ANGIOGRAPHY
CORONARY-ARTERY-DISEASE
CT ANGIOGRAPHY
ELEVATION MYOCARDIAL-INFARCTION
EXPERT CONSENSUS DOCUMENT
General & Internal Medicine
Life Sciences & Biomedicine
MAGNETIC-RESONANCE
MEDIA THICKNESS
Medicine, General & Internal
prevention
PRIMARY PREVENTION
PROGNOSTIC VALUE
risk assessment
Science & Technology
STROKE PATIENTS
Publication Status
Published
Coverage Spatial
Switzerland
Article Number
5563
Date Publish Online
2023-08-26