Current Problems in Cardiology
Volume 34, Issue 11 , Pages 539-577, November 2009

How to Identify the Asymptomatic High-Risk Patient?

Abstract 

Worldwide, cardiovascular diseases are among the leading causes of mortality and morbidity with ever-increasing prevalence. Early targeted initiation of preventive measures would be of great benefit and can provide a major opportunity in reducing mortality and morbidity. To this end, accurate identification of individuals who are still asymptomatic but at elevated risk is essential. However, traditional risk assessment fails to recognize a substantial proportion of patients at high risk while a large proportion of individuals are classified as having intermediate risk, leaving management uncertain. Additional strategies to further refine risk assessment are therefore highly needed. To this end, the use of biomarkers and noninvasive imaging modalities has been proposed. The aim of this review is to provide an overview of the different approaches that are available or under development to improve the identification of asymptomatic individuals at elevated risk for cardiovascular diseases events.

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 Financial support: Jeroen J. Bax: Medtronic (Tolochenaz, Switzerland), Boston Scientific (Maastricht, The Netherlands), BMS Medical Imaging (N. Billerica, MA), St. Jude Medical (Veenendaal, The Netherlands), Biotronik (Berlin, Germany), GE Healthcare (St Giles, UK), and Edwards Lifesciences (Saint-Prex, Switzerland); Jagat Narula: grant support NIH/NHLBI R01 HL 078681 and NIH/NHLBI RO 1 HL 68657. Stephan Achenbach is partly supported by Grant BMBF 01 EV 0708 from Bundesministerium für Bildung und Forschung (BMBF), Bonn, Germany. In addition he receives research support from siemens Health Care, Bayer Schering Pharma, Servier.

PII: S0146-2806(09)00095-4

doi:10.1016/j.cpcardiol.2009.07.001

Current Problems in Cardiology
Volume 34, Issue 11 , Pages 539-577, November 2009