Coronary artery disease: new insights into the pathophysiology, prevalence and early detection of a monster menace.
Coronary artery disease (CAD) is the leading cause of morbidity and mortality in the United States and industrialized countries. In the undeveloped world a similar epidemic is brewing. A new pathophysiologic paradigm has emerged, which assigns the mediators of inflammation a much larger role in the disease process. This paradigm has helped explain the unpredictable nature of many adverse consequences of CAD. The long latent phase of the disease and often sudden initial presentation make efforts at early detection extremely important. Considerable work has been devoted to identify as well as influence predisposing risk factors for developing arteriosclerosis. Novel markers of inflammation, like C-reactive protein, have been identified and compared to traditional risk factors. In addition, new imaging modalities introduce the possibility of screening for sub-clinical disease. Electron-beam and spiral CT scanners, as well as other techniques, are emerging as powerful tools to detect early disease presence and allow intervention to take place before major clinical events occur. Advances in our understanding of the pathophysiology and our ability to image the stages of silent disease will go hand in hand to revolutionize our approach to prevention and treatment of this deadly disease.
New York University Medical Center, New York, NY 10019, USA. jslater@slrhc.org
James
J
Slater
Velisar
V
Rill
D002097:C-Reactive Protein / Q000378:metabolism; D002114:Calcinosis / Q000175:diagnosis; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000378:metabolism / Q000401:mortality / Q000503:physiopathology; D005080:Exercise Test; D006801:Humans; D018810:Magnetic Resonance Angiography; D015995:Prevalence; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000379:methods
D002097:C-Reactive Protein