MODERN APPROACHES TO THE ASSESSMENT OF SUBCLINICAL ATHEROSCLEROSIS AND MULTI-BIOMARKER RISK PREDICTION: PROSPECTS FOR PERSONALIZED PREVENTION OF CARDIOVASCULAR DISEASES

Abstract

The article discusses modern approaches to the assessment of subclinical atherosclerosis and multi-biomarker risk prediction in conditions of continuing high mortality from diseases of the circulatory system and limited accuracy of traditional stratification scales. It was shown that the use of averaged prognostic models did not fully reflect the individual characteristics of atherogenesis, which justified the need to identify subclinical atherosclerosis as an early and clinically significant stage of the cardiovascular continuum, as well as the integration of instrumental imaging methods and laboratory panels into personalized prevention algorithms focused on preventing events at the preclinical stage. The information base of the study was made up of Russian and foreign clinical recommendations and data from population and clinical trials in 2021-2025 on subclinical atherosclerosis, methods of its instrumental diagnosis and multi-biomarker risk assessment models. The methodological basis was an analytical and comparative review of publications with an assessment of the prognostic significance of imaging and laboratory markers, their impact on risk reclassification and the possibility of inclusion in personalized prevention strategies. The study systematized modern approaches to the diagnosis of subclinical atherosclerosis, assessment of its prognostic role, and the inclusion of imaging data and multi-biomarker panels in models of personalized prevention of cardiovascular diseases. It was found that methodological limitations remained due to the heterogeneity of diagnostic criteria, the variability of imaging protocols and laboratory techniques, as well as insufficient external validation of integral models and the uncertainty of their impact on clinical decisions in Russian populations. The necessity of developing unified risk stratification algorithms providing for the standardized inclusion of instrumental and biochemical markers followed by a clinical and economic assessment of their effectiveness in practical healthcare is substantiated. The results obtained confirmed the feasibility of integrating signs of subclinical atherosclerosis and multi-biomarker models into clinical risk assessment algorithms, which was of practical importance for earlier detection of latently high cardiovascular risk and the justification of personalized preventive interventions in real clinical practice.