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Challenges and Opportunities in Coronary Artery Disease

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Theme Issue:

Challenges and Opportunities in Coronary Artery Disease

Coronary artery disease (CAD) remains a leading global health burden, demanding continuous innovation in both prevention and treatment strategies. This theme issue brings together state-of-the-art perspectives that examine the evolving landscape of CAD management, from precision diagnostics and advanced imaging modalities to the role of lifestyle interventions and novel pharmacotherapies.

Emerging opportunities are explored alongside persistent challenges, including disparities in access to care, optimizing revascularization strategies, and balancing evidence-based medicine with individualized patient needs. Contributions also highlight the integration of digital health tools, such as wearable technologies and artificial intelligence, in risk prediction and long-term monitoring.

With growing attention to multidisciplinary collaboration and patient-centered care, this collection underscores the importance of translating scientific advances into meaningful clinical outcomes. Together, these articles illuminate the complexities of CAD while charting new directions for improving cardiovascular health worldwide.

This theme issue was organised in collaboration with the Cardiovascular Disease Committee.

Learn more about the committee

Contents

Research Article

Generic Risk Stratification and the Primary Prevention of Coronary Artery Diseases

Coronary artery disease is the most common cause of death in the world 37. Secondary prevention has a major effect on both cardiac morbidity and mortality and is in large part responsible for the 50% reduction in cardiac mortality observed in the U.S. Primary prevention is more effective and probably necessary to significantly decrease the pandemic prevalence of this disease. Currently there are no biomarkers to detect risk for CAD in young asymptomatic individuals. The current conventional risk factors used to identify individuals at risk for CAD, with the exception of plasma cholesterol LDL-C, are often not present until the sixth or seventh decade of life. This is late for primary prevention since coronary atherosclerosis is initiated early in life even in the second and third decade of life. 
 

By Jacques Fair, Esperanza Acuna, and Robert Roberts - Bachelor of Science in Physiology, USA | Executive Director of the Heart and Vascular Institute, St. Joseph’s Hospital and Medical Center in Phoenix, USA

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Research Article

Generic Risk Stratification Will Enhance Primary Prevention of Coronary Artery Diseases

The overall objective of this review is to determine whether the genetic risk score for CAD is an appropriate method to risk stratify for early primary prevention. We reviewed the results of studies that have evaluated the genetic risk score for CAD in over one million cases and controls. Individuals with a high genetic risk score (top 20%) exhibited a one to four fold increased risk of CAD. The genetic risk score should be considered as an additional enhancer to stratify for risk in the primary prevention of CAD.


By Robert Roberts and Esperanza Acuna

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Research Article

False Positive Results on Dobutamine Stress Echocardiography: A New Marker of Risk for Ischemic Events

The AFP result on DSE was associated with higher mean blood pressure values during the test and higher rates of acute myocardial infarction during follow-up. Therefore, this result on DSE should be used as a risk marker for ischemic events. It can identify patients who may benefit from aggressive risk factor control and careful clinical follow-up.

By Lisa Ferraz, Andreia Fernandes, Ana Faustino, Simão Carvalho, Adriana Pacheco, and Ana Neves - Centro Hospitalar do Baixo Vouga, Aveiro, Portugal

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Research Article

The US Centers for Medicare & Medicaid Services’ (CMS) Failure to Provide Payment for Invasive FFR has Resulted in Worse and Inequitable Medicare Beneficiary Healthcare

The unintended consequences of the US Centers for Medicare & amp; Medicaid Services’ (CMS) decision not to pay for invasive diagnostic FFR (Fractional Flow Reserve) have precluded its routine diagnostic use in hundreds of thousands of Medicare beneficiaries who suffered inappropriate coronary stent procedures (PCI) that worsened Medicare beneficiaries’ clinical outcomes: 20% of PCI patients have no or uncertain clinical indications but are nevertheless operated upon, and 33% of potential PCI stenoses are non-ischemic and require no PCI.
 

By Gerald Dorros, M.D., FACC

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Research Article

Necrotizing Pancreatitis: A comprehensive review of the presentation, management, and complications

Necrotizing pancreatitis (NP) is a life-threatening complication of acute pancreatitis. It requires an extended hospital stay, aggressive management, and a higher risk of mortality. Risk factors such as comorbidities in the patient’s history, including a history of coronary artery disease and cerebrovascular disease, can increase the risk of developing necrotizing pancreatitis. The presentation of necrotizing pancreatitis is similar to acute pancreatitis, but specific labs such as hematocrit levels can be monitored to anticipate the development of necrotizing pancreatitis.

By George Trad, MD, Rasiq Zackria, DO, Syed Abdul Basit, MD, and John K. Ryan, MD - Internal Medicine Residency Program, Sunrise Health GME Consortium, Las Vegas, NV Gastroenterology and Hepatology Fellowship Program, Sunrise Health GME Consortium, Las Vegas, NV; Comprehensive Digestive Institute of Nevada, Las Vegas, NV

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