Alejandro González Veliz: Targeting Atherosclerosis Before the First Event
Alejandro González Veliz, Interventional Cardiologist at Institute of Cardiology and Cardiovascular Surgery, shared a post on LinkedIn about a recent article by L. Badimon, et al., published in Atherosclerosis, adding:
”A New Era In Atherothrombosis
Atherosclerosis is no longer viewed simply as a process of lipid accumulation.
It is a dynamic disease involving the interaction of lipids, inflammation, endothelial dysfunction, thrombosis, and vascular biology.
And this changes the way we think about treatment.
Intensive lipid lowering has shown that modifying LDL-C can do more than reduce future cardiovascular events — it can slow plaque progression and, in some settings, promote plaque regression and stabilization.
But residual risk remains.
Inflammation, Lp(a), remnant lipoproteins, thromboinflammation, metabolic dysfunction, and residual plaque burden may all contribute to ongoing cardiovascular risk.
At the same time, advanced imaging such as CAC, CCTA, and vascular ultrasound is allowing us to identify atherosclerosis before the first clinical event.
The emerging concept is therefore not simply:
‘How do we prevent the next MI?’
But rather: ‘Can we identify atherosclerosis earlier and modify its natural history before it causes an event?’
The future may involve earlier detection, deeper biological characterization, simultaneous targeting of multiple pathways, and increasingly personalized prevention.
The goal may be shifting from simply preventing events to modifying the disease that causes them.
Atherosclerosis may not always be inevitable progression.
In selected patients and at the right stage, disease modification may become a realistic therapeutic goal.”
Title: A new era in atherothrombosis
Authors: L. Badimon, G. Vilahur, G. Mendieta
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