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Biomarkers of Coronary Plaque Composition and Vulnerability

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Biomarkers in Cardiovascular Disease

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Abstract

An important challenge to facing the epidemic of cardiovascular disease is the unpredictable nature of acute coronary events. Therefore, substantial research has been recently conducted in order to develop new methods to identify subjects at risk or atheromatous plaque that are prone to produce sudden major coronary events. Over the past two decades, the concept of “vulnerable plaque” has gained attention as a paradigm to improve risk stratification and potentially lead to the discovery of novel markers of risk to prevent cardiovascular disease.

We reviewed biochemical markers that have been investigated to date for the identification of coronary atherosclerotic plaque composition and early detection of their vulnerability. C-reactive protein and matrix metalloproteinases are the most commonly studied, but also novel biomarkers reflecting a variety of pathophysiologic pathways such as ischemia, inflammation, vascular dysfunction, biomechanical stress, hemostasis, and lipid metabolism have been reported to be potentially associated with increased risk of coronary events.

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Abbreviations

ACS:

Acute coronary syndrome

CRP:

C-reactive protein

CVD:

Cardiovascular disease

LDL:

Low-density lipoprotein

MACE:

Major adverse cardiovascular events

MI:

Myocardial infarction

MMP:

Matrix metalloproteinases

PCI:

Percutaneous coronary intervention

TCFA:

Thin-cap fibroatheromas

VSMC:

Vascular smooth muscle cells

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Authors and Affiliations

  1. Department of Cardiovascular Sciences, Division of Cardiology, European Hospital, Via Portuense, 700-00149, Rome, Italy

    Leonardo De Luca & Fabrizio Tomai

Authors
  1. Leonardo De Luca
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  2. Fabrizio Tomai
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Correspondence to Fabrizio Tomai .

Editor information

Editors and Affiliations

  1. Department of Biomedical Sciences, University of Westminster, London, United Kingdom

    Vinood B. Patel

  2. Sciences Division, King's College, London, United Kingdom

    Victor R. Preedy

Definitions

Acute coronary syndrome

Any condition brought on by sudden, reduced blood flow to the heart

Culprit lesion

The coronary lesion involved in the initial myocardial infarction

Nonculprit lesion

Any lesion in the entire coronary tree outside the culprit lesion

Thin-cap fibroatheromas

Lesions with a fibrous cap <65 μm with macrophage infiltration (>25 cells/high-magnification field) and an underlying necrotic core

Vulnerable plaque

A kind of atheromatous plaque that is particularly unstable and prone to produce sudden major coronary events

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De Luca, L., Tomai, F. (2015). Biomarkers of Coronary Plaque Composition and Vulnerability. In: Patel, V., Preedy, V. (eds) Biomarkers in Cardiovascular Disease. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-7741-5_44-1

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  • DOI: https://doi.org/10.1007/978-94-007-7741-5_44-1

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  • Online ISBN: 978-94-007-7741-5

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