Coronary artery disease: New diagnostic techniques for its early detection
Coronary heart disease is one of the main causes of mortality in modern Western societies. In the USA, which is an excellent epidemiological observation model due to its multiculturalism, it affects 14 million patients. In Europe, in-hospital mortality ranges from 3-5% (acute NSTEMI myocardial infarction) to 7% (acute STEMI myocardial infarction).
Known risk factors include age, male gender, and heredity, while lifestyle factors include a diet rich in saturated fat, cholesterol, and calories, smoking, elevated cholesterol levels, hyperglycemia/diabetes, and arterial hypertension.
The pathophysiology of coronary artery disease, as it may manifest itself (chronic/stable coronary artery disease, acute coronary syndromes) is mostly due to atheromatosis of the coronary vessels. In addition to modifying the above risk factors for its occurrence and further development, its prevention is also very important.
Newer diagnostic techniques are being added to the classic stress test and expand early diagnosis. For example, computed tomography coronary angiography – where indicated – has a very high predictive value, which is close to 99%. Dynamic echocardiographic study, with sensitivity and specificity reaching around 85%. While, cardiac magnetic resonance imaging under stress conditions (stress cMRI) also has a very high sensitivity approaching 95%.
Of course, the above examinations acquire particular value and keep pace with technological developments and the experience of medical personnel. To these are added newer data regarding the therapeutic quiver as well as treatment protocols. Thus, the stabilization of any atherosclerotic plaque is sought, through primary or secondary prevention (in patients who have already suffered an episode) with the aim of converting them from vulnerable to stable.
