title: Current possibilities for detecting high risk of cardiovascular disease.
abstract: Current possibilities for better detecting high risk of coronary heart disease (CHD) and stroke and peripheral arterial disease are described in this review. A first step is based on risk factors assessment that allows establishing high-risk diagnostic, either by detecting a condition termed as "CHD risk equivalent" and defined by one or more severe major risk factor, or by calculating multifactorial risk in asymptomatic subjects with a global risk score integrating several moderate risk factors. A second diagnostic step, concerning subjects not considered at high-risk by risk factors assessment, is based on non-invasive detection of sub clinical atherosclerosis via a wide variety of structural and functional arterial markers. A third step focuses on detection of myocardial ischemia that may add diagnostic and prognostic information in subjects with high CHD risk. The implementation of high-risk strategy is not yet standardized but it should allow improving cost-effectiveness of cardiovascular prevention, particularly in asymptomatic subjects.
authors.affiliation: Centre de Médecine Préventive Cardiovasculaire, Hôpital Broussais Assistance Publique Hôpitaux de Paris-Faculté de Médecine René Descartes, France. alain.simon@brs.ap-hop-paris.fr
authors.forename: Alain
authors.initials: A
authors.lastname: Simon
authors.forename: Wuliya
authors.initials: W
authors.lastname: Mijiti
authors.forename: Jerome
authors.initials: J
authors.lastname: Gariepy
authors.forename: Jaime
authors.initials: J
authors.lastname: Levenson
mesh_terms: D050197:Atherosclerosis / Q000175:diagnosis* / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000503:physiopathology; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D015415:Biomarkers