Kosmas I Paraskevas, Alan Dardik, Marc L Schermerhorn, Christos D Liapis, Armando Mansilha, Brajesh K Lal, William A Gray, Martin M Brown, Piotr Myrcha, Carl J Lavie, Clark J Zeebregts, Eric A Secemsky, Luca Saba, Matthew Blecha, Victor Gurevich, Mauro Silvestrini, Ales Blinc, Alexei Svetlikov, Jose Fernandes E Fernandes, Peter A Schneider, Peter Gloviczki, Christopher J White, Ali F AbuRahma
{"title":"Why selective screening for asymptomatic carotid stenosis is currently appropriate: a special report.","authors":"Kosmas I Paraskevas, Alan Dardik, Marc L Schermerhorn, Christos D Liapis, Armando Mansilha, Brajesh K Lal, William A Gray, Martin M Brown, Piotr Myrcha, Carl J Lavie, Clark J Zeebregts, Eric A Secemsky, Luca Saba, Matthew Blecha, Victor Gurevich, Mauro Silvestrini, Ales Blinc, Alexei Svetlikov, Jose Fernandes E Fernandes, Peter A Schneider, Peter Gloviczki, Christopher J White, Ali F AbuRahma","doi":"10.1080/14779072.2024.2330660","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Two of the main reasons recent guidelines do not recommend routine population-wide screening programs for asymptomatic carotid artery stenosis (AsxCS) is that screening could lead to an increase of carotid revascularization procedures and that such mass screening programs may not be cost-effective. Nevertheless, selective screening for AsxCS could have several benefits. This article presents the rationale for such a program.</p><p><strong>Areas covered: </strong>The benefits of selective screening for AsxCS include early recognition of AsxCS allowing timely initiation of preventive measures to reduce future myocardial infarction (MI), stroke, cardiac death and cardiovascular (CV) event rates.</p><p><strong>Expert opinion: </strong>Mass screening programs for AsxCS are neither clinically effective nor cost-effective. Nevertheless, targeted screening of populations at high risk for AsxCS provides an opportunity to identify these individuals earlier rather than later and to initiate a number of lifestyle measures, risk factor modifications, and intensive medical therapy in order to prevent future strokes and CV events. For patients at 'higher risk of stroke' on best medical treatment, a prophylactic carotid intervention may be considered.</p>","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":null,"pages":null},"PeriodicalIF":1.8000,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Expert Review of Cardiovascular Therapy","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/14779072.2024.2330660","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/3/18 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Two of the main reasons recent guidelines do not recommend routine population-wide screening programs for asymptomatic carotid artery stenosis (AsxCS) is that screening could lead to an increase of carotid revascularization procedures and that such mass screening programs may not be cost-effective. Nevertheless, selective screening for AsxCS could have several benefits. This article presents the rationale for such a program.
Areas covered: The benefits of selective screening for AsxCS include early recognition of AsxCS allowing timely initiation of preventive measures to reduce future myocardial infarction (MI), stroke, cardiac death and cardiovascular (CV) event rates.
Expert opinion: Mass screening programs for AsxCS are neither clinically effective nor cost-effective. Nevertheless, targeted screening of populations at high risk for AsxCS provides an opportunity to identify these individuals earlier rather than later and to initiate a number of lifestyle measures, risk factor modifications, and intensive medical therapy in order to prevent future strokes and CV events. For patients at 'higher risk of stroke' on best medical treatment, a prophylactic carotid intervention may be considered.
期刊介绍:
Expert Review of Cardiovascular Therapy (ISSN 1477-9072) provides expert reviews on the clinical applications of new medicines, therapeutic agents and diagnostics in cardiovascular disease. Coverage includes drug therapy, heart disease, vascular disorders, hypertension, cholesterol in cardiovascular disease, heart disease, stroke, heart failure and cardiovascular surgery. The Expert Review format is unique. Each review provides a complete overview of current thinking in a key area of research or clinical practice.