LAUSR

Guerri-Guttenberg et al demonstrated that coronary intimal thickening was present in 10% of fetuses, a third of the infants, 73.3% of the children, and virtually all the adolescents’ hearts obtained from fetuses, children, and adolescent patients deceased from noncardiac disease or trauma. They concluded that intimal thickening may be the first event occurring in coronary preatherosclerosis, preceding lipid deposition. The increased prevalence of coronary intimal thickening in fetuses, infants, and young children may be associated with the increased prevalence of premature coronary artery disease (CAD) reported in adults. Premature CAD is increasingly common in certain Asian countries and is strongly associated with the development of acute coronary syndromes. In turn, CAD severity is associated with abdominal aortic intima– media thickness and increased insulin resistance. These associations suggest a predisposition to cardiovascular diseases from a very early stage in fetal/infant life. The identification of specific risk markers in infants and fetuses able to predict the development of cardiovascular diseases later in life is crucial. Increased peripheral blood visfatin levels in neonates have been suggested to serve as prognostic markers for the development of several diseases in adult life, including insulin resistance/type 2 diabetes mellitus and CAD/ cardiovascular disease. Future studies should aim to develop early vascular disease detection and prevention models to guide the timely diagnosis and optimal management of premature vascular disease.