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September 2026 Br J Cardiol 2026;33:115–8 doi:10.5837/bjc.2026.043

Let’s be CLEAR: Cath Lab Evaluation of Atherosclerotic Risk is a disease modifying opportunity

Brian Cunneen, Daniel O’Callaghan, Carmel O’Callaghan, Francis O’Neill, Bryan Loo, Peter Wheen, David Moore, David Mulcahy, Richard Armstrong, Vincent Maher

Abstract

Introduction Coronary artery disease (CAD) remains one of the leading causes of mortality worldwide,1 accounting for nine million deaths globally in 2021.2 Numerous modifiable risk factors are associated with its development and progression, including dyslipidaemia, glycaemic control and smoking.3–9 Effective management of risk factors can reduce or even reverse the disease process.10–15 Screening for risk factors, however, is often sporadic and opportunistic in nature. Indeed, even after they are identified, gaps in treatment are common, with patients frequently falling short of updated guideline targets.16-20 It has been shown that when

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