Subclinical Coronary Atherosclerosis: Significance in Cardiovascular Risk Stratification
Cardiovascular diseases remain the leading cause of mortality and morbidity worldwide and represent the highest proportion of costs in healthcare systems. In the vast majority of cases, the pathomorphological basis of coronary heart disease is coronary artery atherosclerosis. Many of the recent research have been devoted to the study of the early stage of atherosclerosis - subclinical atherosclerosis. Destabilization of hemodynamically insignificant, asymptomatic atherosclerotic plaques can lead to the development of myocardial infarction. The article discusses the prevalence and clinical significance of non- obstructive atherosclerosis of the coronary arteries. Special attention is devoted to the scales of cardiovascular risk stratification. Modern methods of coronary atherosclerosis diagnosis, methods of visualization of unstable atherosclerotic plaques are outlined. Considering that it is impossible to assess the instability of atherosclerotic plaque in real clinical practice, the presence of subclinical coronary atherosclerosis itself allows the patient to be classified as high and very high risk.