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Review article

The Evolving Understanding and Approach to Residual Cardiovascular Risk Management

Devinder S. DhindsaDivision of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Atlanta, GA, United StatesPratik B. SandesaraDivision of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Atlanta, GA, United StatesMichael D. ShapiroSection on Cardiovascular Medicine, Center for the Prevention of Cardiovascular Disease, Wake Forest Baptist Medical Center, Winston-Salem, NC, United StatesNathan D. WongHeart Disease Prevention Program, Division of Cardiology, University of California, Irvine, Irvine, CA, United States
2020en
ABI

Abstract

Despite unprecedented advances in treatment of atherosclerotic cardiovascular disease, it remains the leading cause of death and disability worldwide. Treatment of major traditional risk factors, including low-density lipoprotein-cholesterol, serves as the foundation of atherosclerotic risk reduction. However, there remains a significant residual risk of cardiovascular events despite optimal risk factor management. Beyond traditional risk factors, other drivers of residual risk have come to the forefront, including inflammatory, pro-thrombotic, and metabolic pathways that contribute to recurrent events and are often unrecognized and not addressed in clinical practice. This review will explore the evidence linking these pathways to atherosclerotic cardiovascular disease and potential future therapeutic options to attenuate residual cardiovascular risk conferred by these pathways.

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