Noninvasive methods like coronary artery calcium score and carotid imaging can detect subclinical atherosclerosis to predict future cardiovascular events beyond conventional risk factor assessment.
Despite advanced drug therapy, percutaneous intervention, and surgery, atherosclerotic cardiovascular disease remains a major cause of morbidity and mortality worldwide. Atherosclerosis has a long subclinical stage before it manifests clinically, which can be detected early, leading to more appropriate use of primary prevention measures. Several noninvasive methods to detect subclinical atherosclerosis have been explored to predict future cardiovascular events. Carotid imaging and coronary artery calcium score have shown their ability to predict beyond conventional risk factor-based assessment. Other common methods are femoral plaque assessment, the diameter of the aorta, calcification of the descending aorta, ankle–brachial index, and endothelial function test. Current guidelines recommend coronary calcium score for better risk stratification of the intermediate-risk group and statin therapy with a higher score. The clinical utility of other methods needs to be explored further. Lifestyle change and statin therapy may be reinforced to improve outcomes with the detection of atherosclerosis during the subclinical stage.
Mishra et al. (Thu,) conducted a review in Subclinical Atherosclerosis. Noninvasive imaging (coronary calcium score, carotid imaging) vs. Conventional risk factor-based assessment was evaluated. Noninvasive methods like coronary artery calcium score and carotid imaging can detect subclinical atherosclerosis to predict future cardiovascular events beyond conventional risk factor assessment.
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