When Does Primary Prevention Encroach on Secondary Prevention?

IF 5.7 2区医学 Q1 PERIPHERAL VASCULAR DISEASE Current Atherosclerosis Reports Pub Date : 2024-09-01 Epub Date: 2024-07-08 DOI:10.1007/s11883-024-01227-1

Matthew R Deshotels, Prasanti Alekhya Kotta, Juan Simon Rico Mesa, Olamide Adeola Oyenubi, Vijay Nambi

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Abstract

Purpose of review: The risk of incident atherosclerotic cardiovascular disease (ASCVD) in primary prevention is typically lower than in secondary prevention. However, there is a spectrum of risk among individuals undergoing primary prevention with the risk in some individuals approaching those of secondary prevention. We review the clinical conditions wherein the risk in primary prevention is similar to that observed in secondary prevention.

Recent findings: Among individuals without established ASCVD, coronary artery calcium (CAC) scores ≥ 300 AU are associated with ASCVD event rates similar to secondary prevention populations. CAC score ≥ 1,000 AU are associated with an ASCVD risk seen in very high-risk secondary prevention populations. Interpretation of these observations must however consider differences in the risk reduction strategies. Current guidelines dichotomize ASCVD prevention into primary and secondary prevention, but certain primary prevention patients have an ASCVD risk equivalent to that of secondary prevention populations. Identifying higher risk primary prevention populations will allow for better risk mitigation strategies.

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一级预防何时侵犯二级预防？

审查目的：一级预防发生动脉粥样硬化性心血管疾病（ASCVD）的风险通常低于二级预防。然而，在接受一级预防的人群中存在不同程度的风险，有些人的风险接近二级预防的风险。我们回顾了一级预防风险与二级预防风险相似的临床情况：最新发现：在未确诊为 ASCVD 的人群中，冠状动脉钙化（CAC）评分≥ 300 AU 与 ASCVD 事件发生率相关，与二级预防人群相似。CAC 评分≥ 1,000 AU 与极高风险的二级预防人群的 ASCVD 风险有关。但是，对这些观察结果的解释必须考虑降低风险策略的差异。目前的指南将 ASCVD 预防分为一级预防和二级预防，但某些一级预防患者的 ASCVD 风险与二级预防人群相当。识别风险较高的一级预防人群将有助于制定更好的风险缓解策略。

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 Atherosclerosis Reports 医学-

CiteScore

9.00

自引率

3.40%

发文量

审稿时长

6-12 weeks

期刊介绍： The aim of this journal is to systematically provide expert views on current basic science and clinical advances in the field of atherosclerosis and highlight the most important developments likely to transform the field of cardiovascular prevention, diagnosis, and treatment. We accomplish this aim by appointing major authorities to serve as Section Editors who select leading experts from around the world to provide definitive reviews on key topics and papers published in the past year. We also provide supplementary reviews and commentaries from well-known figures in the field. An Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research.

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