Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX (F.R.G., J.D.B., A.K., A.M.S., J.A.d.L.).
Department of Medicine, University of Texas at Tyler (J.D.B.).
Circulation. 2024 Nov 19;150(21):1720-1731. doi: 10.1161/CIRCULATIONAHA.124.070081. Epub 2024 Nov 18.
Precision medicine aims to provide personalized clinical care guided by tools that reflect underlying pathophysiology. The need for such an approach has never been greater in cardiovascular medicine, given the large number of guideline-directed medical therapies available. However, progress has been modest to date with few precision tools available for clinicians. Arguably, cardiovascular prevention and population health are poised for innovation to guide evaluation and management, as these areas are already informed by risk-assessment, but limited by the use of crude assessment tools with marginal performance. Risk assessment in prevention and population health may be improved with the use of genetics, circulating biomarkers, and imaging, leading to outcome-specific risk-prediction and enhanced phenotyping. Personalized management matching therapy to risk profile can be then implemented for either individuals or groups, improving cost-effectiveness and risk-benefit. Here, we explore this precision-like approach, including available tools, potential applications, and future perspectives for cardiovascular prevention and population health management.
精准医学旨在提供基于反映潜在病理生理学的工具的个性化临床护理。鉴于有大量可用的指南指导的医学治疗方法，心血管医学对这种方法的需求从未如此之大。然而，迄今为止进展甚微，可供临床医生使用的精准工具寥寥无几。可以说，心血管预防和人群健康正处于创新的边缘，以指导评估和管理，因为这些领域已经通过风险评估来指导，但受到使用粗糙评估工具的限制，这些工具的性能有限。通过使用遗传学、循环生物标志物和影像学，可以改善预防和人群健康中的风险评估，从而进行特定于结果的风险预测和增强表型分析。然后可以为个人或群体实施匹配风险概况的个性化管理，提高成本效益和风险效益。在这里，我们探讨这种类似精准的方法，包括可用的工具、潜在的应用以及心血管预防和人群健康管理的未来展望。
