Subclinical atherosclerosis: what it is, what it means and what we can do about it.
Atherosclerosis is a chronic, progressive, inflammatory disease with a long asymptomatic phase. Disease progression can lead eventually to the occurrence of acute cardiovascular events such as myocardial infarction, unstable angina pectoris and sudden cardiac death. While the disease is still in a subclinical stage, however, the presence of atherosclerosis can be identified by several methods, including coronary angiography, intravascular ultrasonography, B-mode ultrasonography, computed tomography and magnetic resonance imaging. Based on the results of imaging studies, statin therapy can slow, halt or even reverse the progression of atherosclerotic disease, depending on the intensity of treatment. Whether to screen and treat patients for subclinical atherosclerosis remains controversial. Although atheromatous plaque burden reduction has not yet been definitively correlated with significant decreases in risk for acute coronary events in asymptomatic patients, statin therapy contributes significantly to the risk reduction observed in clinical trials in patients with and without overt coronary disease.
Sterling Rock Falls Clinic, Sterling, and University of Illinois College of Medicine, Peoria, IL 61008, USA. peter.toth@srfc.com
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D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D002340:Carotid Artery Diseases / Q000517:prevention & control; D003327:Coronary Disease / Q000517:prevention & control; D018450:Disease Progression; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008019:Life Style; D008297:Male; D008403:Mass Screening / Q000458:organization & administration; D008875:Middle Aged; D018579:Patient Selection; D011237:Predictive Value of Tests; D012307:Risk Factors; D040242:Risk Reduction Behavior
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors