Interní Med. 2016; 18(1): 9-13 | DOI: 10.36290/int.2016.003

Detection of early stages of atherosclerosis

doc. MUDr. Jan Piťha, CSc.

Laboratoř pro výzkum aterosklerózy, Centrum experimentální medicíny, Institut klinické a experimentální medicíny, Praha

One of the main efforts of preventive cardiology is to detect persons at high cardiovascular risk yet before clinical manifestation of atherosclerosis, which could be fatal. In general, three approaches are discussed: 1) Algorithms calculating the risk of cardiovascular events based on traditional cadiovascular risk factors, 2) Measurements of the concentration of circulating biomarkers, including genetic parameters and 3) Morphological and functional methods assessing vascular wall or obstructive lesions; this group often labelled as detection of preclinical atherosclerosis. The contribution of these approaches could be viewed from several aspects. The most important aspect is whether particular method could help in decision to implement aggressive pharmacologic therapy focused mainly on higher levels of LDL cholesterol or high blood pressure. Historically accepted approaches are established algorithms based on traditional risk factors. More recent methods contribute to the better assessment of cardiovascular risk only moderately. In more complicated patients, however, these approaches/methods could help with treatment decisions. From this perspective the most reliable are measurement of ankle brachial index, detection of preclinical atherosclerosis at the carotid arteries by ultrasound, the pulse wave velocity and calcium score of coronary arteries.

Keywords: cardiovascular events, early atherosclerosis, vascular biomarkers, methods of detection

Published: February 1, 2016  Show citation