Paper:
https://x.com/MariosGeorgakis/status/1919472544773444082
Or what that NICK D person says
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While a study like this is interesting, I don’t think it gives us very much actionable. I also don’t really like these “omics” studies where things are categorised. For example, in that Venn diagram, PCSK1 in listed under “BP”, but it seems to play more of a role in insulin and obesity. HAND2 is best known for importance in cardiac development/maturation. TBX20 is also a cardiac maturation gene. So I’m not totally sure why they’re all under “BP”, and it’s not clear from the paper how that determination was made.
To answer the question: markers of atherosclerosis that you can easily measure:
cIMT if you’re lazy or only have access to ultrasound.
CTA if you want actual data. I recently did one, and it was so fast and easy and effortless, it just seems common sense. Radiation is negligible. Risk of contrast agent is negligible. And you can get actual information - is there plaque, where is it, is it hard or soft, are any arteries actually showing stenosis? It’s also somewhat actionable, since severe stenosis can be dealt with by stents.
To me, most other measurements now seem pointless. For all the effort of a stress test (ECG, treadmill, getting sweaty etc), it doesn’t tell you much unless you have severe inducible ischemia. Even then, you probably knew that without the test because you felt chest tightness when climbing stairs. However, plenty of people have perfect stress tests and still get heart attacks. Similar for a calcium score - you can have a score of zero, lots of soft plaque, and still have a heart attack, so there’s not much to learn from it. The major benefit simply seems to be that it’s a bit cheaper than a CTA.
Hell, zooming out even further, I would question how much value there is in even “measuring” atherosclerosis for most people, since it largely isn’t actionable. Until we can plausibly reverse it, correct for it, and prevent heart attacks (stents don’t seem particularly effective at this part), the most viable approach for most people is reducing risk factors (BP, smoking, ApoB, soon Lp(a), body weight etc). And those are things that arguably everybody should be doing, and you can do it effectively with a few basic blood tests and 2-3 cheap pills.
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