To explore the residual risk in atherosclerotic cardiovascular disease (ASCVD) in China and propose a multimodal strategy for its assessment and management beyond lipid levels, considering the significant burden of cardiovascular disease in the country.
Approach:
Implementation Strategy: The article suggests immediate priorities for implementation, including Lp(a) assessment, hs-CRP evaluation, and intensified management of atherosclerotic risk factors, while addressing the challenges of limited routine testing and healthcare infrastructure.
Key Findings:
Residual risk in ASCVD persists despite meeting lipid level guidelines due to factors like inflammation and genetic predispositions, with current practices in China not routinely incorporating hs-CRP and Lp(a) assessments.
Hs-CRP is recognized as a valuable inflammatory-risk marker, while Lp(a) reflects genetically influenced risk not captured by standard lipid panels.
In China, routine measurement of hs-CRP and Lp(a) testing is limited, impacting the assessment of residual risk.
Interpretation:
The integration of hs-CRP and Lp(a) into routine practice could enhance the understanding and management of residual risk in ASCVD patients in China, although further validation is needed.
Limitations:
Current practices in China do not routinely incorporate hs-CRP and Lp(a) assessments, which limits the ability to fully address residual risk.
The hs-CRP threshold for treatment decisions is not yet validated as a definitive guideline, posing challenges for clinical application.
Conclusion:
A comprehensive strategy involving the assessment of inflammatory markers and intensified management of risk factors is essential for addressing residual risk in ASCVD in China, highlighting the need for urgent action to improve current practices.
Survey results reveal the long-term socio-economic and psychological impacts of single ventricle congenital heart disease (SVHD) on families. See how cardiologists Deepti Bhat, MD, and Naim Duran, MD, contributors to this research, are using findings to transform Fontan Clinic care at Phoenix Children’s.
Patients with lower nonischemic resting full-cycle ratio values had more repeat revascularizations despite similar 2-year major cardiovascular event rates.
