1. Preventive cardiology efforts begin with assessment of CVD risk.
2. Despite many available risk assessment approaches, a substantial gap remains in the detection of asymptomatic individuals who ultimately develop CHD.
3. Most MIs are caused by low-grade stenoses.
4. Criteria required for a good screening test
a) Provides an accurate determination of the likelihood that an asymptomatic person has the condition.
b) Reproducible results.
c) Detect individuals where early intervention is likely to have a beneficial impact.
d) Should provide incremental value to risk predicted by office-based assessment.
5. Role for a complementary approach predicting ASCVD risk
a) Global risk assessment with family history and other measures.
b) Biomarkers (ideally predicting near-term risk).
c) Subclinical disease imaging for atherosclerotic burden.
Dr. Nathan Wong is a cardiovascular epidemiologist and Professor and Director, Heart Disease Prevention Program, Division of Cardiology at the University of California, Irvine in California. He holds MPH and PhD degrees in epidemiology from Yale University and is a fellow of the American College of Cardiology, American Heart Association, National Lipid Association, and American Society for Preventive Cardiology He is a past president of the American Society for Preventive Cardiology and Pacific Lipid Association (Chapter of the National Lipid Association), and president-elect of the Interamerican Heart Foundation. Dr. Wong has primary research interests in subclinical atherosclerosis, lipid and diabetes management, and cardiovascular disease epidemiology and prevention and has authored over 300 papers and co-edited six textbooks, including the Braunwald Companion on Preventive Cardiology and the ASPC Manual on Preventive Cardiology.
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