Alperi Alberto, Antuna Paula, Almendárez Marcel, Álvarez Rut, Del Valle Raquel, Pascual Isaac, Hernández-Vaquero Daniel, Avanzas Pablo
Hospital Universitario Central de Asturias, Oviedo, 33011 Asturias, Spain.
Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Asturias, Spain.
J Clin Med. 2025 Feb 25;14(5):1539. doi: 10.3390/jcm14051539.
Coronary artery disease is a highly prevalent disease that constitutes the leading cause of mortality worldwide. Acute coronary syndromes are the most devastating form of presentation of coronary disease, involving the acute formation of a thrombus within the coronary vessel lumen, further leading to flow limitation and diminished myocardial perfusion. Vulnerable plaques, which are characterized by thin-cap fibroatheroma, a large lipid pool, and macrophage infiltration and spotty calcification of the cap, pose a higher risk of coronary events despite not being flow-limiting. Iterations in intravascular imaging and coronary computed tomography have largely increased the ability to detect and define vulnerable plaques, and its clinical impact in early- and mid-term outcomes has been confirmed in several studies. In this review, we aimed to revise the current concept of vulnerable coronary plaque and its repercussion, to summarize the main pharmacological approaches for its management, and to provide an updated overview of the available evidence on preventive percutaneous interventional strategies in this clinical setting.
冠状动脉疾病是一种高度流行的疾病，是全球范围内主要的死亡原因。急性冠状动脉综合征是冠心病最具破坏性的表现形式，涉及冠状动脉管腔内血栓的急性形成，进而导致血流受限和心肌灌注减少。易损斑块的特征是薄帽纤维粥样斑块、大脂质池、巨噬细胞浸润以及帽部散在钙化，尽管不会造成血流受限，但发生冠状动脉事件的风险更高。血管内成像和冠状动脉计算机断层扫描技术的不断发展，极大地提高了检测和定义易损斑块的能力，多项研究已证实其对早期和中期结果的临床影响。在本综述中，我们旨在修订易损冠状动脉斑块的当前概念及其影响，总结其管理的主要药理学方法，并提供关于该临床环境中预防性经皮介入策略现有证据的最新概述。
