Arora Satish, Nicholls Stephen J
Department of Cardiology, Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway.
Drugs Today (Barc). 2008 Sep;44(9):711-8. doi: 10.1358/dot.2008.44.9.1263999.
Coronary heart disease (CHD) is one of the leading causes of morbidity and mortality worldwide and modification of established cardiovascular risk factors has become increasingly important in order to minimize the impact of the disease. In response to the considerable debate regarding the optimal use of therapeutic strategies, a range of biomarkers has been incorporated into clinical development programs in order to ascertain the efficacy of novel agents. In addition, technological advances in imaging of the artery wall now enable the quantification of the extent of atherosclerotic plaque and allow monitoring of serial changes in response to therapeutics. The most sensitive imaging modality to date is intravascular ultrasound (IVUS) which can determine and quantitate atheroma burden and has provided insights regarding the pathophysiology of plaque formation and the potential impact of new antiatherosclerotic therapies. Furthermore, serial IVUS has demonstrated that intensive modification of a number of established risk factors such as lipid levels and blood pressure has a beneficial impact on the rate of disease progression in patients with established CHD.
冠心病（CHD）是全球发病和死亡的主要原因之一，为了尽量减少该疾病的影响，改变已确定的心血管危险因素变得越来越重要。针对关于治疗策略最佳使用的大量争论，一系列生物标志物已被纳入临床开发项目，以确定新型药物的疗效。此外，动脉壁成像技术的进步现在能够对动脉粥样硬化斑块的范围进行量化，并允许监测治疗反应的系列变化。迄今为止最敏感的成像方式是血管内超声（IVUS），它可以确定并定量动脉粥样硬化斑块负荷，并提供了有关斑块形成的病理生理学以及新的抗动脉粥样硬化疗法潜在影响的见解。此外，系列IVUS已证明，对一些已确定的危险因素（如血脂水平和血压）进行强化改变，对已确诊冠心病患者的疾病进展速度有有益影响。
