The SHAPE proposal goes beyond current criteria such as obesity, smoking and cholesterol levels that doctors use to assess a person's odds of heart attack, stroke and other cardiovascular diseases. According to Dr. Morteza Naghavi, chairman of the SHAPE Task Force, those factors are effective at assessing an individual's long-term risk of cardiovascular disease.

Instead, the task force advocates a closer look at the arteries of apparently healthy people, specifically at levels of arterial plaque. These plaques are comprised of fatty deposits that can build up over time in arteries and cause heart attack or stroke.

"Now, we have created a new concept -- of the vulnerable patient," said Naghavi, who is also head of the Association for the Eradication of Heart Attack, which created the task force. "The conventional risk factors are good at estimating risk over the next 10 to 20 years. They do not identify the patient who has an immediate risk. We would look at the subclinical [hidden] presence of disease," he said.

Specifically, the guidelines call for assessment of plaque build-up in the coronary arteries and thickness of the wall of the carotid artery, the main blood vessel leading up the neck to the brain.

"Until SHAPE, there have been no national guidelines for screening subclinical coronary heart disease," Naghavi said in statement. "We encourage hospitals, diagnostic clinics and physicians to comply with SHAPE standards and provide their patients with state-of-the-art preventive care."

According to Fuster, the new approach is necessary, because there has been a failure in educating people about the importance of the standard risk factors.

The kind of screening recommended by the task force would be especially useful in persons with known risk factors, he said. "Half of all smokers develop cardiac disease, but half do not," Fuster pointed out.

Regular arterial screening could let doctors know which of their smoking patients are in the most immediate danger, and a small trial in another group of high-risk diabetics is already under way to test the concept, Fuster added.

More information

For more on the SHAPE task force and the recommendations, head to the Association for Eradication of Heart Attack.

Fish Oil Fat Could Shield IV-Dependent Infants

Doctors have long known that the prolonged feeding via IV -- otherwise known as parenteral nutrition -- can trigger serious liver damage in babies and young children.

Now, researchers at Children's Hospital Boston say IV feeding that includes a fat mixture made from fish oil could help greatly lower that risk.

The findings were published in the July issue of Pediatrics.

Experts aren't sure why IV feeding boosts babies' liver risks. However, many infants who develop this complication die within a year of being diagnosed, unless they receive a liver/small intestine transplant or can be weaned off IV feeding.

In their article, the researchers reported that they saved the lives of two infants by changing the type of fat used in the IV solution. Previously, the researchers had found evidence that the fat used in standard solutions (called Intralipid) contributed to liver disease by causing fat to accumulate in the liver. Intralipid is made largely of soybean oil and is high in omega-6 fatty acids that are known to have an inflammatory effect.

In previous research with mice, the Boston Children's team had tried using another fat called Omegaven -- an IV fat mixture made from fish oil, which contains omega-3 fatty acids. These fatty acids prevent fat accumulation and have anti-inflammatory properties, they noted. The researchers found that IV feeding with Omegaven prevented fat accumulation and liver injury in mice.

The researchers' article detailed how the use of Omegaven in IV solutions reversed liver disease in two babies with intestinal failure.

To date, Omegaven has been used as the fat portion in the solutions of 21 young patients with intestinal failure treated at Children's Hospital Boston. Most of the patients did well, although two died from unrelated causes.

The researchers plan to conduct a formal clinical trial aimed at preventing liver disease in IV recipients.

"Using a fat emulsion consisting solely of fish oils may enable liver toxicity to be treated or prevented entirely in children and adults who are dependent on parenteral nutrition," Dr. Mark Puder, a surgeon, said in a prepared statement.

More information

The U.S. National Library of Medicine has more about parenteral nutrition.