Key result
Imaging-based risk reclassification detects severe asymptomatic CAD prompting CABG and intensive lipid-lowering therapy.
Why the study?
A precise estimate of cardiovascular risk in asymptomatic individuals is a key factor in the primary prevention of cardiovascular disease.
Case Report (n=1)
Additional non-invasive testing such as carotid Doppler and stress echocardiography can effectively reclassify cardiovascular risk and identify severe occult coronary artery disease in asymptomatic individuals with high baseline risk scores.
May support additional imaging to detect occult CAD and initiate therapy in asymptomatic patients; leaves open prospective validation.
Background. A precise estimate of cardiovascular (CV) risk in asymptomatic individuals is a key factor in the primary prevention of CV disease. Case report. In this report describe an asymptomatic individual presenting for CV status assessment. After the CV risk assessment using the SCORE risk charts and Framingham score, additional tests were performed, which provided better insight and reclassification of risk in this individual. Carotid Doppler sonography revealed plaques in the carotid arteries. Non-invasive assessment of coronary flow reserve (stress echocardiography test) demonstrated that a considerable area of the left ventricle is suffering ischemia when stressed. This was an indication for coronarography, which showed severe three-vessel coronary disease, that was later successfully treated by surgical revascularization. A year after the surgery a control stress echocardiography was performed, showing a satisfactory coronary flow reserve. Conclusion. A precise estimate of CV risk in asymptomatic individuals opens the road leading to early diagnosis, adequate therapy, and prevention of CV disease.
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Tasić et al. (2020) conducted a case report in Asymptomatic cardiovascular risk assessment (n=1). Rosuvastatin was evaluated on Total cardiovascular risk. The patient was identified as high risk for cardiovascular events despite being asymptomatic, requiring significant lifestyle modifications and initiation of lipid-lowering therapy.
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