From the Guidelines
Yes, coronary artery disease (CAD) is considered an atherosclerotic cardiovascular disease (ASCVD) event. CAD is actually one of the primary manifestations of ASCVD, which refers to conditions caused by atherosclerosis - the buildup of plaque in the arteries. ASCVD encompasses several clinical conditions including CAD, cerebrovascular disease (such as stroke), peripheral artery disease, and aortic atherosclerosis. When healthcare providers assess cardiovascular risk or determine treatment strategies, they typically consider CAD as an established ASCVD condition, as supported by the 2022 ACC/AHA guideline for the diagnosis and management of aortic disease 1. This classification has important clinical implications, as patients with established ASCVD, including CAD, are generally considered high-risk and may require more aggressive preventive therapies such as high-intensity statins (like atorvastatin 40-80mg or rosuvastatin 20-40mg daily). The presence of CAD as an ASCVD event also influences treatment goals, such as targeting lower LDL cholesterol levels (often below 70 mg/dL or even lower in very high-risk patients), as recommended by the Cholesterol Treatment Trialists’ Collaboration 1. Understanding CAD as an ASCVD event helps guide appropriate risk stratification and treatment intensity in cardiovascular disease management. Key points to consider include:
- CAD is a primary manifestation of ASCVD
- ASCVD encompasses several clinical conditions, including CAD, cerebrovascular disease, peripheral artery disease, and aortic atherosclerosis
- Patients with established ASCVD, including CAD, are generally considered high-risk and may require more aggressive preventive therapies
- Treatment goals for patients with CAD as an ASCVD event include targeting lower LDL cholesterol levels.
From the Research
Definition of ASCVD Events
- ASCVD events refer to atherosclerotic cardiovascular disease events, which include coronary artery disease (CAD), stroke, and peripheral artery disease.
- CAD is considered an ASCVD event, as it is a condition in which the coronary arteries become narrowed or blocked due to atherosclerosis, leading to reduced blood flow to the heart.
Relationship between CAD and ASCVD Events
- Studies have shown that CAD is a significant risk factor for ASCVD events, including myocardial infarction and stroke 2.
- The severity of CAD has been shown to be a predictor of ASCVD events, with more severe CAD being associated with a higher risk of events 2.
- Treatment of CAD, including lipid-lowering therapy and antiplatelet agents, has been shown to reduce the risk of ASCVD events 3, 4.
Classification of CAD as an ASCVD Event
- The American Heart Association and American College of Cardiology consider CAD to be an ASCVD event, and recommend treatment guidelines for secondary prevention of ASCVD events in patients with CAD 2.
- The European Society of Cardiology also considers CAD to be an ASCVD event, and recommends treatment guidelines for secondary prevention of ASCVD events in patients with CAD 2.
Implications of CAD being considered an ASCVD Event
- Considering CAD as an ASCVD event highlights the importance of early detection and treatment of CAD to prevent ASCVD events.
- It also emphasizes the need for a comprehensive approach to managing CAD, including lifestyle modifications, medical therapy, and invasive procedures, to reduce the risk of ASCVD events 5, 6.