{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T22:04:51Z","timestamp":1780610691333,"version":"3.54.1"},"reference-count":60,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,5,24]],"date-time":"2022-05-24T00:00:00Z","timestamp":1653350400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002996","name":"Dutch Heart Foundation","doi-asserted-by":"publisher","award":["CVON2015-17"],"award-info":[{"award-number":["CVON2015-17"]}],"id":[{"id":"10.13039\/501100002996","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Cardiovascular disease (CVD) remains a leading cause of death and disability worldwide. Acute myocardial infarction (AMI) causes irreversible myocardial damage, heart failure, life-threatening arrythmias and sudden cardiac death (SCD), and is a main driver of CVD mortality and morbidity. To control the forecasted increase in CVD burden for both the individual and society, improved strategies for the prevention of AMI and SCD are required. Current prevention of AMI and SCD is directed towards risk-modifying interventions, guided by risk assessment using clinical risk prediction scores (CRPSs) and the coronary artery calcium score (CACS). Early detection of more advanced coronary artery disease (CAD), beyond risk assessment by CRPSs or CACS, is a promising strategy to allow personalized treatment for the improved prevention of AMI and SCD in the general population. We review evidence for further testing, beyond CRPSs and CACS, and therapies focusing on promising targets, including subclinical obstructive CAD, high-risk plaques, and silent myocardial ischemia. We also evaluate the potential of multi-modality imaging to enhance the conduction of adequately powered trials to provide high-quality evidence on the impact of add-on tests and therapies in the prevention of AMI and SCD in asymptomatic individuals. To conclude, we discuss the occurrence of AMI and SCD in individuals currently estimated to be at \u201clow-risk\u201d by the current strategy based on CRPSs, and methods to improve prevention of AMI and SCD in this \u201clow-risk\u201d population.<\/jats:p>","DOI":"10.3390\/jcm11112965","type":"journal-article","created":{"date-parts":[[2022,5,24]],"date-time":"2022-05-24T22:04:06Z","timestamp":1653429846000},"page":"2965","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Multi-Modality Imaging for Prevention of Coronary Artery Disease and Myocardial Infarction in the General Population: Ready for Prime Time?"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6472-9886","authenticated-orcid":false,"given":"Daan","family":"Ties","sequence":"first","affiliation":[{"name":"University Medical Center Groningen, Thorax Centre, Faculty of Medicine, University of Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulien","family":"van Dorp","sequence":"additional","affiliation":[{"name":"University Medical Center Groningen, Thorax Centre, Faculty of Medicine, University of Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabija","family":"Pundziute","sequence":"additional","affiliation":[{"name":"University Medical Center Groningen, Thorax Centre, Faculty of Medicine, University of Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Lipsic","sequence":"additional","affiliation":[{"name":"University Medical Center Groningen, Thorax Centre, Faculty of Medicine, University of Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlijn M.","family":"van der Aalst","sequence":"additional","affiliation":[{"name":"Erasmus Medical Center, Department of Public Health, Erasmus University, 3015 CE Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthijs","family":"Oudkerk","sequence":"additional","affiliation":[{"name":"Institute for Diagnostic Accuracy, University of Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4682-3646","authenticated-orcid":false,"given":"Harry J.","family":"de Koning","sequence":"additional","affiliation":[{"name":"Erasmus Medical Center, Department of Public Health, Erasmus University, 3015 CE Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rozemarijn","family":"Vliegenthart","sequence":"additional","affiliation":[{"name":"University Medical Center Groningen, Department of Radiology, Faculty of Medicine, University of Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pim","family":"van der Harst","sequence":"additional","affiliation":[{"name":"University Medical Center Groningen, Thorax Centre, Faculty of Medicine, University of Groningen, 9713 GZ Groningen, The Netherlands"},{"name":"University Medical Center Utrecht, Department of Cardiology, University of Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1161\/01.cir.0000437741.48606.98","article-title":"2013 ACC\/AHA guideline on the assessment of cardiovascular risk: A report of the American college of cardiology\/American heart association task force on practice guidelines","volume":"129","author":"Goff","year":"2014","journal-title":"Circulation"},{"key":"ref_2","unstructured":"SCORE2 Working Group and ESC Cardiovascular Risk Collaboration (2021). 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