Endotypes: a customized approach to prevent atherosclerotic cardiovascular disease

Atherosclerotic cardiovascular diseases are the first cause of death and disability in Europe.

Atherosclerosis is a silent killer: it progressively infiltrates the vascular wall and suddenly becomes evident with acute and potentially deadly events, such as myocardial infarction and ischemic stroke which represent the bulk of atherosclerotic cardiovascular disease.

Evolution of atherosclerosis is influenced by the interplay of multiple genetic and environmental factors, yet prevention and treatment of atherosclerotic cardiovascular disease are standardized. Therefore, we need to better define the mechanisms underlying the individual evolution of the atherosclerotic disease.

We integrated individual clinical, imaging, and molecular data to identify atherosclerosis-related subtypes, hereafter referred to as endotypes, in 3000 individuals free of overt cardiovascular diseases. We identified four endotypes each one associated with a distinct atherosclerosis risk profile. Our overarching aim is to investigate if endotypes can be implemented in clinical practice for precision medicine.

To this end, we will investigate if endotypes can identify those individuals prone to suffer from severe carotid and coronary atherosclerosis and thereby at higher risk of atherosclerotic cardiovascular disease.

Our results will give a clear indication of the clinical utility of an endotype based approach and show how precision medicine can be implemented in atherosclerotic cardiovascular disease.