An integrated approach to coronary heart disease diagnosis and clinical management

Research output: Contribution to journalReview article

Abstract

The major issue in coronary heart disease (CHD) diagnosis and management is that symptoms onset in an advanced state of disease. Despite the availability of several clinical risk scores, the prediction of cardiovascular events is lacking, and many patients at risk are not well stratified according to the canonical risk factors alone. Therefore, adequate risk assessment remains the most challenging issue. Recently, the integration of imaging data with biochemical markers in a radiogenomic framework has been proposed in many fields of medicine as well as in cardiology. Multimodal imaging and advanced processing techniques can provide both direct (e.g., remodeling index, calcium score, total plaque volume, plaque burden) and indirect (e.g., myocardial perfusion index, coronary flow reserve) imaging features of CHD. Furthermore, the identification of novel non-invasive biochemical markers, mainly focused on plasma and/or serum samples, has increased the specificity of findings, reflecting several pathophysiological pathways of atherosclerosis, the principal actor in CHD. In this context, a multifaced approach, derived from the strengths of all these modalities, appears promising for finer risk stratification and treatment strategies, facilitating the decision-making and clinical management of patients. This review underlines the role of different imaging modalities in the quantification of coronary atherosclerosis and describes novel blood-based markers that could improve diagnosis and have a better predictive value in CHD.

Original languageEnglish
Pages (from-to)3148-3166
Number of pages19
JournalAmerican Journal of Translational Research
Volume9
Issue number7
Publication statusPublished - Jan 1 2017

Fingerprint

Coronary Disease
Imaging techniques
Biomarkers
Multimodal Imaging
Cardiology
Disease Management
Coronary Artery Disease
Atherosclerosis
Perfusion
Risk assessment
Medicine
Calcium
Blood
Decision making
Availability
Plasmas
Serum
Processing
Therapeutics

Keywords

  • Atherosclerosis
  • Biomarkers
  • Coronary heart disease
  • Imaging

ASJC Scopus subject areas

  • Molecular Medicine
  • Clinical Biochemistry
  • Cancer Research

Cite this

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title = "An integrated approach to coronary heart disease diagnosis and clinical management",
abstract = "The major issue in coronary heart disease (CHD) diagnosis and management is that symptoms onset in an advanced state of disease. Despite the availability of several clinical risk scores, the prediction of cardiovascular events is lacking, and many patients at risk are not well stratified according to the canonical risk factors alone. Therefore, adequate risk assessment remains the most challenging issue. Recently, the integration of imaging data with biochemical markers in a radiogenomic framework has been proposed in many fields of medicine as well as in cardiology. Multimodal imaging and advanced processing techniques can provide both direct (e.g., remodeling index, calcium score, total plaque volume, plaque burden) and indirect (e.g., myocardial perfusion index, coronary flow reserve) imaging features of CHD. Furthermore, the identification of novel non-invasive biochemical markers, mainly focused on plasma and/or serum samples, has increased the specificity of findings, reflecting several pathophysiological pathways of atherosclerosis, the principal actor in CHD. In this context, a multifaced approach, derived from the strengths of all these modalities, appears promising for finer risk stratification and treatment strategies, facilitating the decision-making and clinical management of patients. This review underlines the role of different imaging modalities in the quantification of coronary atherosclerosis and describes novel blood-based markers that could improve diagnosis and have a better predictive value in CHD.",
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AU - Infante, Teresa

AU - Forte, Ernesto

AU - Schiano, Concetta

AU - Cavaliere, Carlo

AU - Tedeschi, Carlo

AU - Soricelli, Andrea

AU - Salvatore, Marco

AU - Napoli, Claudio

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