This Article Figures Only Full Text Full Text (PDF) View Related Cardiosource Journal Scan Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Shah, P. K. Search for Related Content PubMed PubMed Citation Articles by Shah, P. K. Related Collections Related Articles

VIEWPOINT AND COMMENTARY: VIEWPOINT

Screening Asymptomatic Subjects for Subclinical Atherosclerosis

Can We, Does It Matter, and Should We?

Atherosclerosis Research Center, Division of Cardiology and Cedars Sinai Heart Institute, Los Angeles, California

Manuscript received February 9, 2009; revised manuscript received September 8, 2009, accepted September 22, 2009.

^_* Reprint requests and correspondence: Dr. Prediman K. Shah, Division of Cardiology and Atherosclerosis Research Center, Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Suite 5531, Los Angeles, California 90048 (Email: shahp{at}cshs.org).

Unheralded vaso-occlusive cardiovascular events (myocardial infarction, sudden death, and stroke) are common manifestations of atherothrombotic vascular disease, and accurate identification of individuals at risk of such events is highly desirable. Risk factor assessment and management have been the cornerstones of preventive strategies but are constrained by less than desirable accuracy and less than optimal compliance, respectively. In selected populations, noninvasive imaging using carotid ultrasound and/or coronary calcium score can incrementally refine risk assessment and may allow for improved adherence and better matching of preventive interventions to the magnitude of risk. Further refinements in the future may also be possible with novel biomarkers and measures of plaque phenotype.

Key Words: asymptomatic • atherosclerosis • screening

Abbreviations and Acronyms   CCS = coronary calcium score   CIMT = carotid artery intima-media thickness   CT = computed tomography   FRS = Framingham risk score   hsCRP = high-sensitivity C-reactive protein   NCEP = National Cholesterol Education Program   RRS = Reynolds Risk Score

Related Articles

Drug Therapy for Hypercholesterolemia: Time to End the Double Standard

Howard A. Cooper
J. Am. Coll. Cardiol. 2010 56: 1861. [Full Text] [PDF]

This article has been cited by other articles:

				E. Lin and W. Hwang Imaging Assessment of Cardiovascular Risk in Asymptomatic Adults Am. J. Roentgenol., December 1, 2011; 197(6): W1046 - W1051. [Abstract] [Full Text] [PDF]

				J. W. McEvoy, M. J. Blaha, K. Nasir, Y. E. Yoon, E.-K. Choi, I.-S. Cho, E.-J. Chun, S.-I. Choi, J. J. Rivera, R. S. Blumenthal, et al. Impact of Coronary Computed Tomographic Angiography Results on Patient and Physician Behavior in a Low-Risk Population Arch Intern Med, July 25, 2011; 171(14): 1260 - 1268. [Abstract] [Full Text] [PDF]

				J. B. Seward Physiological Aging: Window of Opportunity J. Am. Coll. Cardiol. Img., March 1, 2011; 4(3): 243 - 245. [Full Text] [PDF]

				A. N. DeMaria, J. J. Bax, O. Ben-Yehuda, G. K. Feld, B. H. Greenberg, J. Hall, M. Hlatky, W. Y. W. Lew, J. A. C. Lima, A. S. Maisel, et al. Highlights of the Year in JACC 2010 J. Am. Coll. Cardiol., January 25, 2011; 57(4): 480 - 514. [Full Text] [PDF]

				H. A. Cooper Drug Therapy for Hypercholesterolemia: Time to End the Double Standard J. Am. Coll. Cardiol., November 23, 2010; 56(22): 1861 - 1861. [Full Text] [PDF]

				P. K. Shah Reply J. Am. Coll. Cardiol., November 23, 2010; 56(22): 1861 - 1862. [Full Text] [PDF]

				M. S. Lauer Screening Asymptomatic Subjects for Subclinical Atherosclerosis: Not So Obvious J. Am. Coll. Cardiol., July 6, 2010; 56(2): 106 - 108. [Full Text] [PDF]