Editorial 2411 angiography, invasive angiography, and intravascular ultrasound . Conflict of interest: J.L. receives fellowship support from GE, and that treating atherosclerosis when identified is effective in prevent- . serves as a consultant to and holds stock options in Circle CVI and ing plaque progression, changing plaque morphology to a more . Heartflow. A.A. has no conflicts to disclose. 9,10 . stable form, and helps to reduce events significantly. We ag- . gressively treat all individuals with lipid-lowering therapy after the References 1. Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, McQueen M, Budaj first ASCVD events, independent of the risk factor profile (sec- . A, Pais P, Varigos J, Lisheng L; INTERHEART Study Investigators. Effect of poten- ondary prevention). Is it not the time to take the same approach tially modifiable risk factors associated with myocardial infarction in 52 countries upon detection of significant subclinical atherosclerosis to prevent (the INTERHEART study): case–control study. Lancet 2004;364:937–952. 2. Fernandez-Friera L, Fuster V, Lopez-Melgar B, Oliva B, Garcı´a-Ruiz JM, that first event? . Mendiguren J, Bueno H, Pocock S, Iba ´~ nez B, Ferna ´ndez-Ortiz A, Sanz J. Normal For calcium scoring to be considered as the early step towards LDL-cholesterol levels are associated with subclinical atherosclerosis in the ab- personalized medicine, it needs to be interpreted in a personalized sence of risk factors. J Am Coll Cardiol 2017;70:2979–2991. . 3. Schlendorf KH, Nasir K, Blumenthal RS. Limitations of the Framingham risk score fashion with the goal of preventing an ASCVD event not within are now much clearer. Prev Med 2009;48:115–116. 10 years but ideally over the patient’s lifetime. A calcium score <100 4. Graham G, Blaha MJ, Budoff MJ, Rivera JJ, Agatston A, Raggi P, Shaw LJ, Berman should be interpreted differently in a young patient with no identifi- D, Rana JS, Callister T, Rumberger JA, Min J, Blumenthal RS, Nasir K. Impact of . coronary artery calcification on all-cause mortality in individuals with and without able risk factor as compared with an older patient with or without . hypertension. Atherosclerosis 2012;225:432–437. risk factors. In both cases, a calcium score <100 confirms the pres- . 5. Martin SS, Blaha MJ, Blankstein R, Agatston A, Rivera JJ, Virani SS, Ouyang P, Jones ence of atherosclerosis and risk below 7.5% in the next 10 years. . SR, Blumenthal RS, Budoff MJ, Nasir K. Dyslipidemia, coronary artery calcium, and incident atherosclerotic cardiovascular disease: implications for statin therapy from However, for a younger patient, preventing ASCVD events in the the multi-ethnic study of atherosclerosis. Circulation 2014;129:77–86. next 10 years may not be the main issue to be addressed. Therefore, 6. Kim J, McEvoy JW, Nasir K, Budoff MJ, Arad Y, Blumenthal RS, Blaha MJ. Critical . review of high-sensitivity C-reactive protein and coronary artery calcium for the the same calcium score in two different individuals can lead to differ- guidance of statin allocation: head-to-head comparison of the JUPITER and St. ent personalized therapeutic decision-making that is customized to Francis Heart Trials. Circ Cardiovasc Qual Outcomes 2014;7:315–322. that individual’s care. . 7. Valenti V, Hartaigh BO, Cho I, Schulman-Marcus J, Gransar H, Heo R, Truong . QA, Shaw LJ, Knapper J, Kelkar AA, Sciarretta S, Chang HJ, Callister TQ, Min JK. With concerns around radiation dose fading with newer dose re- Absence of coronary artery calcium identifies asymptomatic diabetic individuals duction strategies and cost seemingly no longer an issue in most at low near-term but not long-term risk of mortality: a 15-year follow-up study healthcare environments, we are left with a simple question. What of 9715 patients. Circ Cardiovasc Imaging 2016;9:e003528. . 8. Budoff MJ, Young R, Burke G, Carr JJ, Detrano RC, Folsom AR, Kronmal R, Lima answer needs to be shared for more robust clinical adoption? The JAC, Liu KJ, McClelland RL, Michos E, Post WS, Shea S, Watson KE, Wong ND. investigators in the field of coronary calcification scoring and subclin- Ten-year association of coronary artery calcium with atherosclerotic cardiovas- ical atherosclerosis have consistently provided the same clear answer . cular disease (ASCVD) events: the multi-ethnic study of atherosclerosis (MESA). Eur Heart J 2018;39:2401–2408. and yet it is seemingly not the answer the field of cardiovascular . . ´ 9. Valenti V, O Hartaigh B, Heo R, Cho I, Schulman-Marcus J, Gransar H, Truong medicine wants to hear. Why in an era of calls for individualized care . QA, Shaw LJ, Knapper J, Kelkar AA, Sandesara P, Lin FY, Sciarretta S, Chang HJ, are we willing to ignore such a powerful and yet simple imaging bio- . Callister TQ, Min JK. A 15-year warranty period for asymptomatic individuals without coronary artery calcium: a prospective follow-up of 9,715 individuals. marker? Is it not yet the time to move from risk assessment to direct JACC Cardiovasc Imaging 2015;8:900–909. visualization of the disease? Is it not yet the time to start treating the . 10. Ahmadi A, Narula J. Primary and secondary prevention, or subclinical and clinical disease as opposed to the risk for the disease? atherosclerosis. JACC Cardiovasc Imaging 2017;10:447–450. doi:10.1093/eurheartj/ehy135 Corrigendum Online publish-ahead-of-print 2 January 2018 ................................................................................................ .................................................................. Corrigendum to: The year in cardiology 2017: heart failure [Eur Heart J (2018);39(10):832–839]. The authors of the above paper wishes to inform readers that in the Preamble section of their paper ‘HFpEF; EF > _40%’ has been corrected to ‘HFpEF; EF > _50%’ as a post-publication correction. V C Published on behalf of the European Society of Cardiology. All rights reserved. The Author(s) 2018. For permissions, please email: firstname.lastname@example.org. Downloaded from https://academic.oup.com/eurheartj/article-abstract/39/25/2411/4917783 by Ed 'DeepDyve' Gillespie user on 03 July 2018
European Heart Journal – Oxford University Press
Published: Jan 2, 2018
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