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Multiple step-variable pathway hypothesis: a reason why predictions fail in atherosclerosis

journal contribution
posted on 2023-06-08, 13:48 authored by Gordon FernsGordon Ferns
Cardiovascular risk factors are individually only modest predictors of events, and whilst more sophisticated algorithms appear to improve their prediction, a significant proportion of the population is miscategorised and therefore managed inappropriately. It is proposed that atherogenesis is a multi-step process, and that the critical transitions between steps requires 'bundles' of risk factors that may differ for each step. These bundles may not always contain a classical risk factor and may differ between individuals. This hypothesis would predict that the impact of specific risk factors is non-uniform during atherogenesis and therefore the efficacy of interventions will vary with stage. New therapeutic opportunities exist if the factors that promote progression between particular stages could be identified and targeted. The staging of disease using modalities such as imaging and functional assessment may be necessary to deliver the most effective treatment. Finally, risk assessment will invariably be inaccurate, even using complex algorithms.

History

Publication status

  • Published

Journal

Medical Hypotheses

ISSN

0306-9877

Publisher

Elsevier

Issue

6

Volume

71

Page range

923-926

Department affiliated with

  • Division of Medical Education Publications

Full text available

  • No

Peer reviewed?

  • Yes

Legacy Posted Date

2012-11-19

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    University of Sussex (Publications)

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