Adamopoulou Eleni, Dimitriadis Kyriakos, Kyriakoulis Konstantinos, Pyrpyris Nikolaos, Beneki Eirini, Fragkoulis Christos, Konstantinidis Dimitris, Aznaouridis Konstantinos, Tsioufis Konstantinos
First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 115 27, Athens, Greece.
First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 115 27, Athens, Greece.
Cardiovasc Pathol. 2025 Jul-Aug;77:107736. doi: 10.1016/j.carpath.2025.107736. Epub 2025 Apr 12.
The likelihood of a plaque to cause an acute coronary syndrome (ACS) depends on several factors, both lesion- and patient-related. One of the most investigated and established contributing factors is the presence of high-risk or "vulnerable plaque" characteristics, which have been correlated with increased incidence of major adverse cardiovascular events (MACE). The recognition, however, that a significant percentage of vulnerable plaques do not result in causing clinical events has led the scientific community towards the more multifaceted concept of "vulnerable patients". Incorporating the morphological features of an atherosclerotic plaque into its hemodynamic surroundings can better predict the chance of its disruption, as altered fluid dynamics play a significant role in plaque destabilization. The advances in coronary imaging and the field of computational fluid dynamics (CFD) can contribute to develop more accurate lesion- and patient-related ACS prediction models that take into account both the morphology of a plaque and the forces applied upon it. The aim of this review is to provide the latest data regarding the aforementioned predictive factors as well as relevant preventive measures.
斑块引发急性冠状动脉综合征（ACS）的可能性取决于多个因素，包括病变相关因素和患者相关因素。其中研究最多且已确定的促成因素之一是存在高危或“易损斑块”特征，这些特征与主要不良心血管事件（MACE）的发生率增加相关。然而，认识到相当一部分易损斑块并不会导致临床事件，这使得科学界转向了更具多面性的“易损患者”概念。将动脉粥样硬化斑块的形态特征与其血流动力学环境相结合，可以更好地预测其破裂的可能性，因为改变的流体动力学在斑块不稳定中起着重要作用。冠状动脉成像和计算流体动力学（CFD）领域的进展有助于开发更准确的与病变和患者相关的ACS预测模型，该模型同时考虑了斑块的形态及其所受的作用力。本综述的目的是提供有关上述预测因素以及相关预防措施的最新数据。
