Assessment of cardiovascular disease risk: a 2023 update.

IF 3.8 3区医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY Current opinion in lipidology Pub Date : 2023-08-01 DOI:10.1097/MOL.0000000000000887

Earl Goldsborough, Erfan Tasdighi, Michael J Blaha

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引用次数: 5

Abstract

Purpose of review: The aim of this study was to highlight the current best practice for atherosclerotic cardiovascular disease (CVD) risk evaluation, including selective use of adjunctive tools for risk stratification [e.g. coronary artery calcium (CAC) scoring] and risk enhancement [e.g. lipoprotein(a) [Lp(a)], polygenic risk scoring (PRS)].

Recent findings: New studies have evaluated the efficacy of various risk assessment tools. These studies demonstrate the role of Lp(a) as a risk-enhancing factor ready for more widespread use. CAC is the gold standard method of assessing subclinical atherosclerosis, enabling true risk stratification of patients, and informing net benefit assessment for initiating or titrating lipid-lowering therapy (LLT).

Summary: Lp(a) concentration and CAC scoring, apart from the traditional risk factors, add the most value to the current CVD risk assessment approaches of all available tools, especially in terms of guiding LLT. In addition to new integrative tools such as the MESA CHD Risk Score and Coronary Age calculator, the future of risk assessment may include PRS and more advanced imaging techniques for atherosclerosis burden. Soon, polygenic risk scoring may be used to identify the age at which to begin CAC scoring, with CAC scores guiding preventive strategies.

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心血管疾病风险评估:2023年更新。

回顾目的:本研究的目的是强调当前动脉粥样硬化性心血管疾病(CVD)风险评估的最佳实践，包括选择性使用辅助工具进行风险分层[如冠状动脉钙(CAC)评分]和风险增强[如脂蛋白(a) [Lp(a)]，多基因风险评分(PRS)]。最新发现:新的研究评估了各种风险评估工具的有效性。这些研究表明，Lp(a)是一种风险增强因子，可以更广泛地使用。CAC是评估亚临床动脉粥样硬化的金标准方法，能够对患者进行真正的风险分层，并为开始或滴定降脂治疗(LLT)的净收益评估提供信息。总结:Lp(a)浓度和CAC评分，除了传统的风险因素外，是目前所有可用工具中最有价值的心血管疾病风险评估方法，特别是在指导LLT方面。除了新的综合工具，如MESA冠心病风险评分和冠状动脉年龄计算器，未来的风险评估可能包括PRS和更先进的动脉粥样硬化负担成像技术。不久，多基因风险评分可能用于确定开始CAC评分的年龄，CAC评分指导预防策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current opinion in lipidology 医学-内分泌学与代谢

CiteScore

6.70

自引率

4.50%

发文量

审稿时长

6-12 weeks

期刊介绍： With its easy-to-digest reviews on important advances in world literature, Current Opinion in Lipidology offers expert evaluation on a wide range of topics from six key disciplines including nutrition and metabolism, genetics and molecular biology, and hyperlipidaemia and cardiovascular disease. Published bimonthly, each issue covers in detail the most pertinent advances in these fields from the previous year. This is supplemented by a section of Bimonthly Updates, which deliver an insight into new developments at the cutting edge of the disciplines covered in the journal.