A Promising Pathway Toward Mitigation and Eradication of Coronary Artery Disease

Abstract

Cardiovascular disease remains the leading cause of death in the United States and globally. Significant advances have been made throughout the history of cardiology and the treatment of this disease; however, these efforts have not halted the alarming statistics. Emerging approaches, such as artificial intelligence applied to cardiac imaging, genetic testing, and genetic silencing, may offer essential additional steps in treating the disease. Moreover, new pathways of the disease are being identified, which differ from traditional risk factors and offer a fresh, innovative approach. This paper focuses on a novel strategy that includes identifying and treating multiple pathways of the disease using both new and traditional interventions. These interventions include plaque-directed therapy rather than surrogate therapy, with the potential to mitigate consequences and possibly eradicate the disease through personalized, multi-approach treatments similar to those used in cancer treatment.

Keywords: Artificial intelligence; Cardiac computed tomography; Clonal hematopoiesis; Coronary artery disease; Genome wide association studies; Plaque; Polygenic risk score; RNA.

Figure 1

Summary of the pathway for the eradication of CAD. This general overview begins with identifying individuals with unknown risk, followed by testing coronary CTA and AI-based plaque analysis, combined with genetic profiling using a polygenic risk score (PRS) to assess risk. The next step is personalized therapy, concluding with ongoing follow-up to prevent future events. AI: artificial intelligence; CAD: coronary artery disease; CTA: computed tomographic angiography.

Figure 2

Summary of multiple contributors to atherosclerosis and CAD, also a simple but comprehensive flowchart is proposed with the use of personalized combination of medications using non-RNA and RNA drugs. CAD: coronary artery disease; RNA: ribonucleic acid.