Personalized Intervention Based on Early Detection of Atherosclerosis: JACC State-of-the-Art Review

Rikke V Nielsen*, Valentin Fuster, Henning Bundgaard, Jose J Fuster, Amer M Johri, Klaus F Kofoed, Pamela S Douglas, Axel Diederichsen, Michael D Shapiro, Stephen J Nicholls, Børge G Nordestgaard, Jes S Lindholt, Calum MacRae, Chun Yuan, David E Newby, Elaine M Urbina, Göran Bergström, Martin Ridderstråle, Matthew J Budoff, Morten BøttcherOlli T Raitakari, Thomas H Hansen, Ulf Näslund, Henrik Sillesen, Nikolaj Eldrup, Borja Ibanez

*Corresponding author for this work


Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide and challenges the capacity of health care systems globally. Atherosclerosis is the underlying pathophysiological entity in two-thirds of patients with CVD. When considering that atherosclerosis develops over decades, there is potentially great opportunity for prevention of associated events such as myocardial infarction and stroke. Subclinical atherosclerosis has been identified in its early stages in young individuals; however, there is no consensus on how to prevent progression to symptomatic disease. Given the growing burden of CVD, a paradigm shift is required-moving from late management of atherosclerotic CVD to earlier detection during the subclinical phase with the goal of potential cure or prevention of events. Studies must focus on how precision medicine using imaging and circulating biomarkers may identify atherosclerosis earlier and determine whether such a paradigm shift would lead to overall cost savings for global health.

Original languageEnglish
JournalJournal of the American College of Cardiology
Issue number21
Pages (from-to)2112-2127
Number of pages16
Publication statusPublished - 28 May 2024


  • Humans
  • Atherosclerosis/diagnosis
  • Early Diagnosis
  • Precision Medicine/methods
  • Biomarkers/blood


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