Cardiovascular Disease: Screening & Prevention

CVD: Screening & Prevention

Cardiovascular disease (CVD) is the leading cause of mortality and morbidity worldwide.1 In Europe, CVD is responsible for over 10,000 lives lost every day.2 The high prevalence and mortality associated with CVD underlines the importance of promoting preventative strategies to better manage risk factors early. It has additionally prompted significant research efforts to develop improved screening methods that are better able to identify individuals with elevated risk of developing CVD.3

There are several established methods that doctors around Europe can use to detect the signs of CVD, including, but not limited to, monitoring blood pressure, cholesterol testing, electrocardiogram (ECG), and echocardiography.4 However, recent advances in screening technology have enabled more precise and accurate methods.

Coronary computed tomography angiography (CCTA), also referred to as computed tomography coronary angiography (CTCA), is a non-invasive imaging technique that produces detailed images of the heart’s blood vessels. CCTA is an evolution of traditional CT scans that synchronises image acquisition to the electrocardiogram (ECG) signal to produce high resolution images of the coronary arteries.5 CCTA has demonstrated high accuracy in detecting coronary calcification and coronary artery disease (CAD) which could be used to identify asymptomatic patients at risk for adverse cardiovascular events.6

Imaging is not the only option in a doctor’s screening toolbox, there are several emerging biomarkers that may be useful when it comes to CVD screening. One example is high-sensitivity troponin tests. These blood tests can detect very small amounts of troponin, a protein released into the bloodstream when the heart muscle is damaged.7,8 High-sensitivity troponin tests are more accurate than previous versions, allowing doctors to detect damage to the heart muscle prior to major cardiac events.8 These tests can additionally reveal damage caused by other illnesses (e.g. COVID-19) that could potentially leave individuals at greater risk of serious cardiac events.7

Beyond specific screening techniques, artificial intelligence (AI) algorithms are improving our ability and capacity to analyse large amounts of data from medical records, imaging tests, and other sources to identify patients at high risk for CVD.9 This can help doctors tailor prevention and treatment strategies to each patient’s individual needs.9,10

Prevention of CVD

While early detection through screening is important, prevention remains the most effective way to reduce the chances of developing CVD. Lifestyle modifications such as healthy diet, regular exercise, and smoking cessation can significantly reduce the risk of CVD.11

One of the most important strategies for preventing CVD is to identify and manage risk factors early.11 Risk factors for CVD include high blood pressure, high cholesterol, diabetes, obesity, and smoking.11 It is essential that individuals with an elevated risk of CVD work closely with their healthcare providers to develop a comprehensive CVD prevention plan tailored to their individual needs. By identifying and addressing these risk factors early, individuals can significantly reduce their risk of developing CVD.11

At Daiichi Sankyo we are continually exploring how we can best support CVD patients, including those at risk of developing CVD, beyond the medicines that we’re able to provide. We believe that the implementation of CVD screening as standard, alongside comprehensive prevention strategies, by European health systems would help identify individuals at risk of CVD whilst still asymptomatic, which could considerably reduce the number of serious cardiac events and ultimately improve patient outcomes.

For more information on CVD risk factors and how they can be addressed, take a look at our blog series specifically addressing CVD prevention strategies:

  1. Take Heart Part I: Risk Factors and Prevention of CVD
  2. Take Heart Part II: Risk Factors and Prevention of CVD
References
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Roth, GA., et al. Global Burden of Cardiovascular Disease and Risk Factors. J Am Coll Cardiol. 2020. 76(25): 2982-3021.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7755038/ Last Accessed April 2023.
[2] 

Mach, F., et al. 2020. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk: The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS). Eur Heart J. 2020 Jan, 41(1): 111-188.

https://academic.oup.com/eurheartj/article/41/1/111/5556353 Last Accessed April 2023.
[3] 

Visseren FLJ., et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice: Developed by the Task Force for cardiovascular disease prevention in clinical practice with representatives of the European Society of Cardiology and 12 medical societies With the special contribution of the European Association of Preventive Cardiology (EAPC). Eur Heart J. 2021 Sep, 42(34): 3227-3337.

https://academic.oup.com/eurheartj/article/42/34/3227/6358713?login=false Last Accessed April 2023.
[4] 

NHS choices. (2020). Diagnosis – Coronary Heart Disease.

https://www.nhs.uk/conditions/coronary-heart-disease/diagnosis/ Last Accessed April 2023.
[5] 

Balcombe, J.N. and Litt, H.I. 2011. “Coronary CT Angiography,” in Radiology secrets plus. 3rd edn. Philadelphia, PA: Mosby/Elsevier, pp. 69–76.

https://www.sciencedirect.com/sdfe/pdf/download/eid/3-s2.0-B9780323067942000110/first-page-pdf Last Accessed April 2023.
[6] 

Graby, J. (2021) Risk screening in cardiovascular disease: The role of CT coronary angiography in asymptomatic patients, why wait?, Editorials. British Cardiovascular Society.

https://www.britishcardiovascularsociety.org/resources/editorials/articles/risk-screening-cardiovascular-disease-role-ct-coronary-angiography-asymptomatic-patients Last Accessed April 2023.
[7] 

Sandoval, Y., Januzzi, J.L. and Jaffe, A.S. 2020. Cardiac troponin for assessment of myocardial injury in COVID-19: JACC Review Topic of the Week. Journal of the American College of Cardiology. 2020 Sep, 76(10): 1244–1258.

https://doi.org/10.1016/j.jacc.2020.06.068 Last Accessed April 2023.
[8] 

Xu, R.-yi., et al. 2013. High-sensitive cardiac troponin T. J Geriatr Cardiol. 2013 Mar, 10(1): 102–109.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3627711/ Last Accessed April 2023.
[9] 

Chan, S. (2019) Six challenges in heart disease that artificial intelligence is helping to solve. British Heart Foundation.

https://www.bhf.org.uk/for-professionals/healthcare-professionals/blog/2019/six-challenges-in-heart-disease-that-artificial-intelligence-is-helping-to-solve Last Accessed April 2023.
[10] 

Karatzia, L., Aung, N. and Aksentijevic, D. 2022. Artificial intelligence in cardiology: Hope for the future and power for the present. Front Cardiovasc Med. 2022 Oct, 9.

https://www.frontiersin.org/articles/10.3389/fcvm.2022.945726/full Last Accessed April 2023.
[11] 

World Health Organization. (n.d.). Cardiovascular diseases.

https://www.who.int/health-topics/cardiovascular-diseases/#tab=tab_1 Last Accessed April 2023.

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