Why selective screening for asymptomatic carotid stenosis is currently appropriate: a special report.

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Expert Review of Cardiovascular Therapy Pub Date : 2024-04-01 Epub Date: 2024-03-18 DOI:10.1080/14779072.2024.2330660
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
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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.

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为什么目前适合对无症状颈动脉狭窄进行选择性筛查:特别报告。
导言:最近的指南不建议对无症状颈动脉狭窄(AxCS)进行常规全民筛查,其中两个主要原因是筛查可能会导致颈动脉再血管化手术的增加,而且这种大规模筛查计划可能不具成本效益。然而,选择性筛查 AsxCS 可能会带来一些益处。本文介绍了开展此类计划的理由:选择性筛查 AsxCS 的益处包括:早期识别 AsxCS,及时启动预防措施,降低未来心肌梗死(MI)、中风、心源性死亡和心血管(CV)事件的发生率:专家意见:大规模的 AsxCS 筛查项目既无临床效果,也不具成本效益。然而,对 AsxCS 高危人群进行有针对性的筛查,可以及早发现这些人,并采取一系列生活方式措施、改变危险因素和强化医疗,以预防未来的脑卒中和心血管事件。对于接受最佳药物治疗的 "中风高危 "患者,可以考虑进行预防性颈动脉介入治疗。
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来源期刊
Expert Review of Cardiovascular Therapy
Expert Review of Cardiovascular Therapy CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
3.70
自引率
0.00%
发文量
82
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.
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