Atherosclerotic cardiovascular disease (ASCVD)

ASCVD is a progressive disease characterized by the accumulation of plaques in arterial walls, causing blood vessels to narrow or block. This limits blood flow, increasing the risk of heart attacks, strokes, and other cardiovascular events. The formation of plaques begins early in life, often promoted by inflammation, oxidative stress, and high levels of lipoproteins containing apoB.

Predisposition

Certain medical habits and conditions increase the risk of heart failure.

Obesity

Excess weight puts a strain on the heart and worsens other risk factors.

Sedentary lifestyle

Increases the risk of weakening the heart muscle.

Smoking

Damages blood vessels and increases cardiac workload.

Hypertension

Expresses additional pressure on the heart over time

Symptoms

ASCVD often remains asymptomatic until significant arterial narrowing or blockage occurs, leading to acute cardiovascular events.

Chest pain (angina pectoris)

Discomfort caused by reduced blood flow to the heart.

Shortness of breath

Indicates a decrease in oxygen supply due to restricted blood flow.

Fatigue

Pain or cramps in the legs during activity due to the involvement of peripheral arteries.

Claudication

Pain or cramps in the legs during activity due to the involvement of peripheral arteries.

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Diagnostic

Early detection relies on advanced imaging and biomarker testing to assess arterial health and identify risks.

ApoB test

Measures the number of atherogenic lipoproteins.

Ideal score
‍ <60 mg/dL.

High risk
‍ >130 mg/dL

CAC Scan

Quantifies the calcification of the coronary arteries.

Ideal score<60 mg/dL.

High risk
>300 mg/dL

Test Lp (a)

Assess hereditary risk.

Ideal score
‍ <50 mg/dL

High risk
>100 mg/dL

Fasting insulin test

Detect hyperinsulinemia.

Ideal score<5 μIU/ml

High risk
>20 μIU/ml

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Therapy

ASCVD treatment combines lifestyle interventions, medications, and in severe cases, procedural options to restore blood flow.

Lifestyle changes

Anti-inflammatory diets (for example, Mediterranean)
Regular aerobic and resistance exercise
Quitting smoking

Medications

Statins: Lower LDL cholesterol and stabilize plaques.
PCSK9 inhibitors: Dramatically reduce ApoB levels.
Aspirin: Prevents the formation of clots in high-risk patients.

Surgical procedures

Angioplasty and stent placement to open blocked arteries.
Surgical bypass for severe arterial blockages.