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急性冠脉综合征中的薄帽纤维粥样瘤:血管内影像学评估的意义。

Thin-cap fibroatheroma in acute coronary syndrome: Implication for intravascular imaging assessment.

机构信息

Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China.

Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China.

出版信息

Int J Cardiol. 2024 Jun 15;405:131965. doi: 10.1016/j.ijcard.2024.131965. Epub 2024 Mar 15.

Abstract

Acute coronary syndrome (ACS), a significant cardiovascular disease threat, has garnered increased focus concerning its etiological mechanisms. Thin-cap fibroatheroma (TCFA) are central to ACS pathogenesis, characterized by lipid-rich plaques, profuse foam cells, cholesterol crystals, and fragile fibrous caps predisposed to rupture. While TCFAs may be latent and asymptomatic, their pivotal role in ACS risk is undeniable. High-resolution imaging techniques like Optical coherence tomography (OCT) and Intravascular ultrasound (IVUS) are instrumental for effective TCFA detection. Therapeutic strategies encompass pharmacological and interventional measures, including antiplatelet agents, statins, and Percutaneous Coronary Intervention (PCI), aiding in plaque stabilization, inflammation reduction, and rupture risk mitigation. Despite the strong correlation between TCFAs and adverse prognoses in ACS patients, early detection and rigorous treatment significantly enhance patient prognosis and diminish cardiovascular events. This review aims to encapsulate recent advancements in TCFA research within ACS, covering formation mechanisms, clinical manifestations, and prognostic implications.

摘要

急性冠状动脉综合征(ACS)是一种严重的心血管疾病威胁,其发病机制受到了越来越多的关注。薄帽纤维粥样瘤(TCFA)是 ACS 发病机制的核心,其特征为富含脂质的斑块、大量泡沫细胞、胆固醇结晶和易破裂的脆弱纤维帽。虽然 TCFA 可能是潜伏的和无症状的,但它们在 ACS 风险中的关键作用是不可否认的。光学相干断层扫描(OCT)和血管内超声(IVUS)等高分辨率成像技术是有效检测 TCFA 的工具。治疗策略包括药物和介入治疗,包括抗血小板药物、他汀类药物和经皮冠状动脉介入治疗(PCI),有助于稳定斑块、减轻炎症和降低破裂风险。尽管 TCFA 与 ACS 患者的不良预后之间存在很强的相关性,但早期检测和严格治疗可显著改善患者的预后并减少心血管事件。本综述旨在总结 ACS 中 TCFA 研究的最新进展,涵盖其形成机制、临床表现和预后意义。

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