prevention of heart attack, stroke, myocardial infarction.our method
DESCRIPTION
Cardiovascularprevention.con is a website for prevention of cardiovascular disease. Heart attack, sudden death or stroke is the first sign of cardiovascular disease in one third of healthy people. In this slide presentation you can find our innovative methods for assesing the first sign of atherosclerosis and the managment of cardiovascular risk in healty individuals...and more.TRANSCRIPT
Searching for Vulnerable Subject g j
Best results for the Patient
• Actual Model(symptoms) 43% Survival
Best results for the Patient
( y p )CVD’s Risk Factors, Drugs, CABG, Devices…
• Long Term Model 85% SurvivalgGenetic Panel
Select and monitor
85% SurvivalSignificant impact on
productivity and Costs Population at riskTreat specific Patients
p ysaving.
Treat specific Patients2www.cardiovascularprevention.com
Who is the Vulnerable Subject ?j
He is an High risk person:- Asymptomatic
h i b li i l h l i- having subclinical atherosclerosisnot detectable by common risk factor assessment
He needs aggressive treatment , but he do not know it- Almost all vulnerable individuals have detectable subclinical atherosclerosis- New technology can identify vulnerable individuals with
ffi i t di tisufficient predictive power
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Cholesterol FailedCholesterol Failed
Quantification of Cholesterol and common Risk Factors failed to predict more than 1/3 of future cardiac death rising from Ischemic heart disease
LDL Goal Cholesterol LDL goals are progressively lowered for CVD prevention, in agree to
Patient 2001* 2004†
High-risk < 100 < 70
NCEP panel IIIModerate-risk < 130 < 100
Low-risk < 160 < 160
4NCEP ATP III = National Cholesterol Education Program Adult Treatment Panel III; LDL = low-density
lipoprotein: Charles H. Hennekens, MD; Medscape General Medicine. 2006;8(1):54. www.cardiovascularprevention.com
Carotid Intima Media Thickness (CIMT)Carotid Intima-Media Thickness (CIMT)
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CALCIUM SCORECALCIUM SCOREI th l t l ifi ti t t• In the normal artery calcification are not present.
• The presence of coronary calcification indicates the existence of coronary diseasethe existence of coronary disease.
• The amount of calcification was correlated with the amount of plaque and the number ofthe amount of plaque and the number of coronary stenoses.
• The research of coronary calcium is an excellent ymethod of screening asymptomatic patients.
• The positive predictive power varies from 20 to 35% d ti di ti i l t35% and negative predictive power is close to 100%.
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CALCIUM SCORE ASSOCIATED WITH OTHER RISK FACTORS
(From: Raggi e coll. Am. Heart J. March 2001).
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SURVIVAL IN RELATION TO CALCIUM SCORE
Survival in 4474 males 3219 females with more than one risk factor in relation to the values of calcium scores measured by EBCT
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in relation to the values of calcium scores measured by EBCT (Bethesda conference, Jacc 41, 11 2003)
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Coronary TC Angiography and Calcium score
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Coronary TC Angiography 3D rendering
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Coronary TC AngiographyCoronary TC Angiography
Little calcified plaque(arrows)
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Coronary TC Angiography
Proximal LAD
Small calcifiedSmall calcified plaque (arrows)
particular
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Coronary TC Angiography
Cx Artery and collateral branch
RA and IVP artery
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Right Artery and small septal vessels(arrows)g y p ( )
Coronary TC Angiography Traditional Coronary Angiography
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Searching for Vulnerable Subject CV Risk Personal rankingCV Risk Personal ranking
Very High Risk: >20%
High: >2%High :6<20%g
Intermediate : 0.6-5,9 %
L <0 5 %15
Low: <0.5 %www.cardiovascularprevention.com
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Noninvasive Screening for Coronary Artery Disease With ComputedNoninvasive Screening for Coronary Artery Disease With Computed Tomography Is Useful
Melvin E. Clouse, MD,
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Our Program:Discover the Vulnerable Subject
§ Clinical historyActual MethodOur Method
§ y
§ Common Risk Factors study
Risk Factors evaluation in agreement of F i h d l§ New CVD's Markers
§ C I M T
Framingham model and
NCEP Panel III =§ Calcium Score Index
§ Coronary CT
Insufficient 50%
§ Coronary CT angiography (if indicated)
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www CardioVascularPrevention comwww.CardioVascularPrevention.com
23E-mail: [email protected]