In 2001, Dr. Naghavi, the founder of SHAPE invited cardiology leaders to answer these 10 questions. Now after 15 years it is interesting to review the answers and compare the predictions with the reality. The fact is that very little to no progress has been made for the early detection of vulnerable patients and for the prevention of sudden heart attacks. Preventive cardiology is at least 15 years behind and needs to innovate and move faster!
Q1. Statistics indicate that over 50% of first-time heart attack victims die suddenly before reaching hospital, and this has been the case since 1960s? Does this mean that the field of cardiovascular medicine is fundamentally handicapped in reaching 50% of its target population? How can we break this statistics?
In 2001, Dr. Naghavi, the founder of SHAPE invited cardiology leaders to answer these 10 questions. Now after 15 years it is interesting to review the answers and compare the predictions with the reality. The fact is that very little to no progress has been made for the early detection of vulnerable patients and for the prevention of sudden heart attacks. Preventive cardiology is at least 15 years behind and needs to innovate and move faster!
Q2. Autopsy series and recent IVUS studies indicate that more than 50% of adults have some degree of atherosclerotic plaque, therefore the question is who has vulnerable plaque. Do you agree that we should focus on screening for vulnerable plaque instead of atherosclerosis? Do you think that risk factors of vulnerable plaque might be different from risk factors of atherosclerosis?
In 2001, Dr. Naghavi, the founder of SHAPE invited cardiology leaders to answer these 10 questions. Now after 15 years it is interesting to review the answers and compare the predictions with the reality. The fact is that very little to no progress has been made for the early detection of vulnerable patients and for the prevention of sudden heart attacks. Preventive cardiology is at least 15 years behind and needs to innovate and move faster!
Q.3- We know that a significant number of patients with coronary artery disease do not have any of the traditional risk factors, and on the other hand some people with high cholesterol and other risk factors live long (80s y) but never experience heart attack? What does it mean to you? Do we know enough? Should we look for protective factors?
In 2001, Dr. Naghavi, the founder of SHAPE invited cardiology leaders to answer these 10 questions. Now after 15 years it is interesting to review the answers and compare the predictions with the reality. The fact is that very little to no progress has been made for the early detection of vulnerable patients and for the prevention of sudden heart attacks. Preventive cardiology is at least 15 years behind and needs to innovate and move faster!
Q.4- Do you agree that besides vulnerable plaque we should pay attention to vulnerable (trombogenic) blood and also vulnerable (electrically unstable) myocardium? In other words should we go beyond plaque and focus on vulnerable patient?
In 2001, Dr. Naghavi, the founder of SHAPE invited cardiology leaders to answer these 10 questions. Now after 15 years it is interesting to review the answers and compare the predictions with the reality. The fact is that very little to no progress has been made for the early detection of vulnerable patients and for the prevention of sudden heart attacks. Preventive cardiology is at least 15 years behind and needs to innovate and move faster!
Q.5- How would you describe “vulnerable plaque” and “vulnerable patient” to general health-conscious population?
In 2001, Dr. Naghavi, the founder of SHAPE invited cardiology leaders to answer these 10 questions. Now after 15 years it is interesting to review the answers and compare the predictions with the reality. The fact is that very little to no progress has been made for the early detection of vulnerable patients and for the prevention of sudden heart attacks. Preventive cardiology is at least 15 years behind and needs to innovate and move faster!
Q.6- Should health-conscious patients ask their doctors to check their CRP and calcium score? How about non-invasive MR or CT coronary angiography?
In 2001, Dr. Naghavi, the founder of SHAPE invited cardiology leaders to answer these 10 questions. Now after 15 years it is interesting to review the answers and compare the predictions with the reality. The fact is that very little to no progress has been made for the early detection of vulnerable patients and for the prevention of sudden heart attacks. Preventive cardiology is at least 15 years behind and needs to innovate and move faster!
Q.7- Do you think that plaques diagnosed either by thermography (hot plaque) or elastography (soft plaque) etc. (e.g. upper quintile in each) should be stented by drug-eluding stent even if they are not stenotic (<50%)? Will you be completely satisfied if the rate of restenosis is less than 10% or will you be looking for a pan-arterial treatment instead of multiple stenting?
In 2001, Dr. Naghavi, the founder of SHAPE invited cardiology leaders to answer these 10 questions. Now after 15 years it is interesting to review the answers and compare the predictions with the reality. The fact is that very little to no progress has been made for the early detection of vulnerable patients and for the prevention of sudden heart attacks. Preventive cardiology is at least 15 years behind and needs to innovate and move faster!
Q.8- Do you anticipate a serum screening test like PSA to identify the risk of near-future heart attack? How about a home-based kit for genetic profiling and screening of vulnerable patients? Are these realistic wishes or only fantasies?!
In 2001, Dr. Naghavi, the founder of SHAPE invited cardiology leaders to answer these 10 questions. Now after 15 years it is interesting to review the answers and compare the predictions with the reality. The fact is that very little to no progress has been made for the early detection of vulnerable patients and for the prevention of sudden heart attacks. Preventive cardiology is at least 15 years behind and needs to innovate and move faster!
Q.9- Do you anticipate any breakthrough like vaccine against heart attack? Can sudden heart attack be eradicated one day, as smallpox is today?
In 2001, Dr. Naghavi, the founder of SHAPE invited cardiology leaders to answer these 10 questions. Now after 15 years it is interesting to review the answers and compare the predictions with the reality. The fact is that very little to no progress has been made for the early detection of vulnerable patients and for the prevention of sudden heart attacks. Preventive cardiology is at least 15 years behind and needs to innovate and move faster!
Q10- As a leader in cardiovascular medicine, do you have vulnerable plaque?!! If you might, how would you take care of your vulnerable plaque?