Anthropology and archeology meet preventive cardiology? They will today in the 15th Annual Maseri-Florio International Lecture where the featured speaker, Jagat Narula, DM, MD, PhD, MACC, will address the burden of cardiovascular disease and share insights from his research, including imaging studies in mummies and special populations, that could inform strategies for promotion of cardiovascular health worldwide.

Cardiovascular disease is the leading noncommunicable disease (NCD) worldwide and remains the leading cause of death globally, contributing nearly half of the NCD-related deaths in 2012, according to estimates from the World Health Organization. Of the 17.5 million deaths that year, an estimated 7.4 million were estimated to be caused by coronary heart disease. Many of these deaths are premature, before the age of 60 years.

More often than not, the first manifestation of coronary artery disease is an acute coronary syndrome event, either a myocardial infarction or sudden cardiac death. Cardiovascular imaging modalities are capable of identifying the high-risk, vulnerable plaque, and one must focus on the high-risk patients and not continue to chase individual plaques, says Narula, who is editor-in-chief of JACC: Cardiovascular Imaging. Atherosclerosis is a diffuse disease. In a decade of follow-up, about one-half of the acute coronary events occur from the high-risk plaques and the other half come from non-high-risk plaques. This has shifted the focus from the vulnerable plaque to the vulnerable patient, and the need to identify patients with this dynamic disease process.

The large-scale, observational INTERHEART study, conducted in 27,000 patients across 52 countries, has demonstrated that more than 90 percent of atherosclerotic disease is attributed to risk factors. The imaging of the mummies by the Horus Group from four different geographic regions and cultures found further evidence that even 4,000 years ago the disease occurred due to the same risk factors.

In his Maseri-Florio lecture, Narula – who is currently the Philip J. and Harriet L. Goodhart Chair in Cardiology, chairman of the departments of cardiology at Mount Sinai West and St. Luke’s Hospitals, and director of cardiovascular imaging at Mount Sinai Health System – will focus on the use of cardiovascular imaging strategies for better understanding the atherosclerotic disease process.

Narula, who is also associate dean at the Arnhold Institute of Global Health at Mount Sinai, will touch on the role of risk factors, the interplay between genes and the environment and the impact on the development of coronary heart disease, and the role of infection and inflammation. He will make a case for promoting global cardiovascular wellness, with strategies to address modifiable risk factors, public health screening of risk factors and education.

“I am grateful to the Maseri-Florio Foundation for their contribution to the important cause of promoting cardiovascular health globally, particularly in low- and middle-income countries,” says Narula.

Keywords: ACC Publications, ACC Annual Scientific Session, Acute Coronary Syndrome, Atherosclerosis, Coronary Artery Disease, Death, Sudden, Cardiac, Follow-Up Studies, Global Health, Myocardial Infarction, Risk Factors

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