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Advancements in risk stratification and management strategies in primary cardiovascular prevention

2024-05-15Journal article Restricted access
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dc.contributor.authorBarkas, Fotios
dc.contributor.authorSener, Yusuf Ziya
dc.contributor.authorGolforoush, Pelin Arabacilar
dc.contributor.authorKheirkhah, Azin
dc.contributor.authorRodriguez-Sanchez, Elena
dc.contributor.authorNovak, Jan
dc.contributor.authorApellaniz-Ruiz, Maria
dc.contributor.authorAkyea, Ralph Kwame
dc.contributor.authorBianconi, Vanessa
dc.contributor.authorCeasovschih, Alexandr
dc.contributor.authorChee, Ying Jie
dc.contributor.authorCherska, Mariia
dc.contributor.authorChora, Joana Rita
dc.contributor.authorD'Oria, Mario
dc.contributor.authorDemikhova, Nadiia
dc.contributor.authorKocyigit Burunkaya, Duygu
dc.contributor.authorRimbert, Antoine
dc.contributor.authorMacchi, Chiara
dc.contributor.authorRathod, Krishnaraj
dc.contributor.authorRoth, Lynn
dc.contributor.authorSukhorukov, Vasily
dc.contributor.authorStoica, Svetlana
dc.contributor.authorScicali, Roberto
dc.contributor.authorStorozhenko, Tatyana
dc.contributor.authorUzokov, Jamol
dc.contributor.authorLupo, Maria Giovanna
dc.contributor.authorvan der Vorst, Emiel P.C.
dc.contributor.authorPorsch, Florentina
dc.date.accessioned2024-07-10T13:01:50Z
dc.date.available2024-07-10T13:01:50Z
dc.date.issued2024-05-15
dc.description.abstractAtherosclerotic cardiovascular disease (ASCVD) remains a leading cause of morbidity and mortality worldwide, highlighting the urgent need for advancements in risk ssessment and management strategies. Although significant progress has been made ecently, 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.pt_PT
dc.description.abstractHighlights: - Recent advancements in ASCVD management focus on identifying at-risk individuals and plaque regression strategies; - ASCVD can manifest without traditional risk factors, necessitating a paradigm shift in preventive approaches; - Targeting plaque progression rather than just traditional risk factors is crucial for preventing adverse events; - Personalised medicine, advanced imaging, and biomarker research offer new avenues for refining risk stratification; - Integrating genetic, imaging, and biomarker data, alongside AI tools, promises to optimize cardiovascular risk management.pt_PT
dc.description.sponsorshipM.A.-R. received a Postdoctoral Junior Leader - INCOMING Fellow ship from “la Caixa” Foundation (ID: 100010434) and from the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska Curie grant agreement No. 847648 (fellowship code: LCF/BQ/PI21/11830009). C.M. is supported by piano di sostegno alla ricerca dotazione 2022 (LINEA 2 AZIONE A), University of Milan. E. R.S. is supported by an AHA grant with the reference 24POST1183446. L.R. is funded by the Research Council of the University of Antwerp (BOF UAntwerp ID: 45846) and the Fund for Scientific Research (FWO)- Flanders (G060723N). E.P.C.v.d.V. is supported by a grant from the Interdisciplinary Center for Clinical Research within the faculty of Medicine at the RWTH Aachen University.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationAtherosclerosis. 2024 May 15:395:117579. doi: 10.1016/j.atherosclerosis.2024.117579. Review. Online ahead of print.pt_PT
dc.identifier.doi10.1016/j.atherosclerosis.2024.117579pt_PT
dc.identifier.issn0021-9150
dc.identifier.urihttp://hdl.handle.net/10400.18/9198
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.relationJunior Leader la Caixa Postdoctoral Fellowship Programme: Shaping the new generation of leaders in research
dc.relation.publisherversionhttps://www.sciencedirect.com/science/article/abs/pii/S0021915024001394?via%3Dihubpt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/pt_PT
dc.subjectCardiovascular Diseasept_PT
dc.subjectAtherosclerosispt_PT
dc.subjectRisk Stratificationpt_PT
dc.subjectPlaque Regressionpt_PT
dc.subjectPrimary Preventionpt_PT
dc.subjectDoenças Cardio e Cérebro-vascularespt_PT
dc.titleAdvancements in risk stratification and management strategies in primary cardiovascular preventionpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.awardTitleJunior Leader la Caixa Postdoctoral Fellowship Programme: Shaping the new generation of leaders in research
oaire.awardURIinfo:eu-repo/grantAgreement/EC/H2020/847648/EU
oaire.citation.startPage117579pt_PT
oaire.citation.titleAtherosclerosispt_PT
oaire.citation.volume395pt_PT
oaire.fundingStreamH2020
project.funder.identifierhttp://doi.org/10.13039/501100008530
project.funder.nameEuropean Commission
rcaap.embargofctAcesso de acordo com política editorial da revista.pt_PT
rcaap.rightsembargoedAccesspt_PT
rcaap.typearticlept_PT
relation.isProjectOfPublicatione715980d-fee2-4057-9784-83c530c44905
relation.isProjectOfPublication.latestForDiscoverye715980d-fee2-4057-9784-83c530c44905

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