Citizens Specialty Hospital, Hyderabad, India; UCL Institute of Cardiovascular Science, London, UK; Royal Free Hospital, London, UK.
Erasmus MC, Thoraxcentre, Rotterdam, the Netherlands; Hippokration Hospital, Athens Medical School, Athens, Greece.
Hellenic J Cardiol. 2021 Mar-Apr;62(2):101-106. doi: 10.1016/j.hjc.2020.06.008. Epub 2020 Jul 3.
Despite significant advances in preventive, medical, and interventional management, coronary artery disease remains the leading cause of death worldwide. We now know that in the majority of acute coronary syndromes, a thrombotic event is triggered either by the rupture or erosion of the so-called high-risk or 'vulnerable' plaque. However, accurately identifying the individual who is at significant risk of acute event remains the holy grail of preventive cardiology. To better stratify an individual's risk of developing and suffering a cardiovascular event, biomarkers are needed that can accurately predict coronary events and, if possible, monitor disease activity in response to medical or interventional therapies. In order to be able to understand the association of these biomarkers with the morphological substrate of high-risk plaques, intravascular imaging modalities can provide invaluable assistance. Novel imaging tools such as optical coherence tomography (OCT) have not only helped in identifying atherosclerotic plaque characteristics that are unstable but also in estimating global plaque burden. In this study, we provide an overview of our current knowledge of association of various inflammatory markers with atherosclerotic plaque characteristics seen on OCT.
尽管在预防、医学和介入治疗管理方面取得了重大进展，但冠状动脉疾病仍然是全球死亡的主要原因。我们现在知道，在大多数急性冠状动脉综合征中，血栓事件是由所谓的高风险或“脆弱”斑块的破裂或侵蚀引发的。然而，准确识别发生急性事件风险显著增加的个体仍然是预防心脏病学的圣杯。为了更好地对个体发生心血管事件的风险进行分层，需要能够准确预测冠状动脉事件的生物标志物，如果可能的话，还需要监测对药物或介入治疗的疾病活动。为了能够理解这些生物标志物与高风险斑块的形态学基质之间的关联，血管内成像方式可以提供非常有价值的帮助。新型成像工具，如光学相干断层扫描（OCT），不仅有助于识别不稳定的动脉粥样硬化斑块特征，还有助于估计整体斑块负担。在这项研究中，我们概述了我们目前对各种炎症标志物与 OCT 上所见动脉粥样硬化斑块特征之间关联的认识。
