scholarly journals Circulating Biomarkers Reflecting Destabilization Mechanisms of Coronary Artery Plaques: Are We Looking for the Impossible?

Biomolecules ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 881
Author(s):  
Marko Kumric ◽  
Josip A. Borovac ◽  
Dinko Martinovic ◽  
Tina Ticinovic Kurir ◽  
Josko Bozic
Keyword(s):  
Coronary Artery ◽  
Vulnerable Plaque ◽  
Cost Effective ◽  
Current Evidence ◽  
Plaque Instability ◽  
Coronary Syndrome ◽  
Non Invasive ◽  
Multiple Biomarkers ◽  
Plaque Destabilization

Despite significant strides to mitigate the complications of acute coronary syndrome (ACS), this clinical entity still represents a major global health burden. It has so far been well-established that most of the plaques leading to ACS are not a result of gradual narrowing of the vessel lumen, but rather a result of sudden disruption of vulnerable atherosclerotic plaques. As most of the developed imaging modalities for vulnerable plaque detection are invasive, multiple biomarkers were proposed to identify their presence. Owing to the pivotal role of lipids and inflammation in the pathophysiology of atherosclerosis, most of the biomarkers originated from one of those processes, whereas recent advancements in molecular sciences shed light on the use of microRNAs. Yet, at present there are no clinically implemented biomarkers or any other method for that matter that could non-invasively, yet reliably, diagnose the vulnerable plaque. Hence, in this review we summarized the available knowledge regarding the pathophysiology of plaque instability, the current evidence on potential biomarkers associated with plaque destabilization and finally, we discussed if search for biomarkers could one day bring us to non-invasive, cost-effective, yet valid way of diagnosing the vulnerable, rupture-prone coronary artery plaques.

Abstract 4008: PSGL-1-Expressing CD4 T Cells are Enriched in Culprit Coronary Artery Lesion of Acute Coronary Syndrome

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Keiko Gomita ◽  
Kayoko Sato ◽  
Kazutaka Kitamura ◽  
Nobuhisa Hagiwara
Keyword(s):  
T Cells ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Adhesion Molecules ◽  
Peripheral Blood ◽  
Cd4 T Cells ◽  
Coronary Artery Lesion ◽  
Plaque Instability ◽  
Coronary Syndrome

Background: Recently, several evidences on the crucial role of adhesion molecules in the development of atherosclerosis and plaque instability have been reported. While expression of VCAM-1, ICAM-1 and L-selectin has been consistently observed in atherosclerotic plaques it is still uncertain how adhesion molecules on T cells contribute to the incidence of acute coronary syndrome (ACS). In this study, we examined whether adhesion molecules on T cells in ACS have a significant role in the plaque stability and prone to cause ACS. Methods and Results: Fresh CD4 T cells were isolated from the peripheral blood of 76 ACS patients (AMI=35, UAP=41) and 74 age-matched controls (NC). CD69, an activation marker of T cells, was strongly expressed on CD4 T cells from ACS than from NC by FACS (P<0.0001). CD4 T cells from ACS highly expressed p-selectin glycoprotein ligand-1 (PSGL-1) and integrin β (CD18), but not L-selectin by FACS (P < 0.03, P < 0.01, n.s., respectively). Soluble PSGL-1 (sPSGL-1) levels in plasma were lower in ACS patients than in NC (P=0.0001), which correlated negatively with the PSGL-1 expression on CD4 T cells (R=0.405, P<0.02). We further investigated the thrombus-aspirating device samples (n=14) and fresh CD4 T cells derived from both the coronary artery and peripheral blood from the each same patient with ACS. CD4 T cells from the coronary artery strongly expressed PSGL-1 (P<0.002), but not integrin β (CD18) and L-selectin by FACS. Finally, PSGL-1 was expressed on T cells, but not on CD68 positive macrophage, MPO positive neutrophil, or CD41 positive platelets in the thrombus-aspirating device samples. Conclusions: From these results, we demonstrated that PSGL-1-expressing CD4 T cells are enriched in the culprit coronary artery lesion of ACS, contributing to the acceleration of plaque instability and occurrence of ACS.

scholarly journals The Emerging Role of Coronary CT in Non-ST Elevation Acute Coronary Syndrome (NSTE-ACS)

2021 ◽  
Vol 42 (2) ◽  
Author(s):  
Jimmy Oi Santoso ◽  
Nurnajmia Curie Proklamartina ◽  
Roy Christian
Keyword(s):  
Acute Coronary Syndrome ◽  
Clinical Practice ◽  
Current Evidence ◽  
Significant Stenosis ◽  
Coronary Syndrome ◽  
Non Invasive ◽  
Coronary Ct ◽  
St Elevation ◽  
Rule Out

NSTEACS is subset of ACS that may present with a wide degree of stenosis from normal vessels to severe obstruction. Identification of which population of NSTEACS that has normal vessels has attracted a great attention. Several trials on non-invasive imaging such as coronary CT have been largely investigated. Current available trials have showed that coronary CT is accurately identify significant stenosis in patients with NSTEACS thus can be used to rule out the disease and reduce the need and duration of unneeded antithrombotic. However, several limitations of the studies has to be taken into account when translating into clinical practice. Nevertheless, current evidence are showing promising results on the role of coronary CT in management of NSTEACS.

Optical coherence tomography and coronary angioscopy assessment of healed vulnerable plaque components in patients with coronary artery lesions undergoing elective percutaneous coronary intervention

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Kimura ◽  
K Hara ◽  
M Ohmori ◽  
R Tateishi ◽  
T Kaneda ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Coronary Artery ◽  
Vulnerable Plaque ◽  
Multivariate Logistic Regression Analysis ◽  
Low Grade ◽  
Optical Coherence ◽  
Coronary Artery Lesions ◽  
Coronary Syndrome ◽  
Yellow Plaque ◽  
Coronary Angioscopy

Abstract Background Many vulnerable plaques would progress without clinical events and might result in healed plaques (HPs). Histopathological or intracoronary image assessment of HPs has been reported. However, the morphological characteristics of HPs remain unclear yet. Purpose We sought to assess the healed vulnerable plaque components in patients with coronary artery lesions using optical coherence tomography (OCT) and coronary angioscopy (CAS). Methods We enrolled 47 patients with 50 native coronary artery lesions with angiographical severe stenosis (&gt;90% diameter-stenosis) and without severe calcification (36 lesions with stable angina pectoris (SAP) and 14 acute coronary syndrome (ACS)) undergoing pre-intervention OCT and CAS. HPs was defined as layered phenotype on OCT. Lesion morphologies and plaque characteristics in lesions with HPs were assessed using OCT and CAS images. Results HPs were observed in 27 lesions (54.0%) and their prevalence were similar among each clinical status (SAP 52.8%, ACS 57.1%, p=1.00). Lesions with HPs had higher prevalence of OCT-macrophage (88.0% vs. 52.0%, p=0.01), CAS-red thrombus (88.8% vs. 52.2%, p=0.004) and CAS-low grade-yellow plaque (grade 1) (55.6% vs. 21.7%, p=0.02) than those without. SAP lesions with HPs had higher prevalence of CAS-yellow plaque (35.3% vs. 5.9%, p=0.09) and OCT-thin-cap fibroatheroma (42.1% vs. 5.9%, p=0.04) than SAP without HPs. ACS lesions with HPs had less CAS-red thrombus (0.0% vs. 50.0%, p=0.03) and OCT-plaque rupture (12.5% vs. 66.7%, p=0.04) than ACS without HPs. Multivariate logistic regression analysis revealed that OCT-macrophages (odds ratio (OR): 6.65, 95%-confidence intervals: 1.07–41.5, p=0.043), CAS-red thrombus (OR 8.77, 95% CI 1.33–57.8, p=0.02), and low grade-yellow plaque (OR 13.05, 95% CI 1.97–86.5, p=0.008) were independently related with the existence of HPs lesions. Combination of these 3 factors showed a high predictive value of OCT-HPs lesions (90.9%). Conclusions HPs lesions showed the lower lesion vulnerability than common ACS lesions but had more intraplaque inflammatory condition compared with common SAP lesions. Combined CAS and OCT examination might be useful to clarify the plaque components of HPs lesions in vivo, leading to help us understand the clinical significance of HPs. Funding Acknowledgement Type of funding source: None

scholarly journals MicroRNAs as Regulators and Biomarkers of Platelet Function and Activity in Coronary Artery Disease

2019 ◽  
Vol 119 (10) ◽  
pp. 1563-1572 ◽  
Author(s):  
Stefan Stojkovic ◽  
Anne Yaël Nossent ◽  
Paul Haller ◽  
Bernhard Jäger ◽  
Kris G. Vargas ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Treatment Response ◽  
Platelet Function ◽  
Ribonucleic Acids ◽  
Coronary Syndrome ◽  
Artery Disease ◽  
Response Biomarkers

AbstractMicroribonucleic acids (miRs) are small, noncoding ribonucleic acids (RNAs), which play an important role in the regulation of platelet function and activity. Several studies proposed a mechanistic role of platelet-related miRs in the pathophysiology of coronary artery disease (CAD) and atherothrombosis. Circulating, platelet-related miRs have been proposed as diagnostic, prognostic, as well as treatment response biomarkers in CAD and acute coronary syndrome (ACS). In this review, we summarize recent studies on the role of platelet-related miRs in the regulation of platelet function and activity. Furthermore, we review the studies investigating the role of platelet-related miRs as biomarkers in patients with CAD and ACS.

scholarly journals Role of territorial speckle tracking echocardiography in identifying the localization of significant coronary artery disease in patients with non-ST-segment elevation acute coronary syndromes

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
E Gherbesi ◽  
G Chiarello ◽  
V L Paiocchi ◽  
L A Leo ◽  
S A Schlossbauer ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Wall Motion ◽  
Speckle Tracking Echocardiography ◽  
St Segment Elevation ◽  
Non Invasive ◽  
St Segment ◽  
Coronary Syndromes ◽  
Wall Motion Abnormalities ◽  
Artery Disease

Abstract Background In non-ST-segment elevation acute coronary syndromes (NSTE-ACS) patients, several studies demonstrated that 2D speckle tracking echocardiography (STE) is able to predict the presence of coronary artery disease (CAD). Conversely, the role of STE for the localization of significant CAD is less well established. Purpose To investigate the role of territorial longitudinal (TLS) and circumferential strain (TCS) assessed with STE as a non-invasive predictor of localization of significant CAD in patients with NSTE-ACS. Methods We retrospectively enrolled NSTE-ACS patients with significant stenosis (≥70%) at least in one major epicardial coronary artery and without previous cardiovascular events over two years of time. Echocardiography was recorded before coronary angiography and myocardial strain was evaluated offline by an operator blinded to clinical data. Territorial strain was calculated grouping and averaging the strain values of the segments perfused by the 3 major coronary arteries. Results 150 patients were included (age 66.3±11.8 years, 71% male; 90.7% NSTEMI and 9.3% unstable angina). ROC curve analysis demonstrated the ability of TLS and TCS to identify the presence of coronary stenosis of LAD, LCX or RCA (AUC for TLS-LAD 0.74 [0.66–0.82] p=0.0001; LCX 0.73 [0.65–0.81] p=0.0001; RCA 0.69 [0.60–0.77] p=0.0001-AUC for TCS-LAD 0.80 [0.70–0.90] p=0.0001; LCX 0.76 [0.67–0.85] p=0.0001; RCA 0.65 [0.55–0.75] p=0.0001), superior to territorial wall motion score index (Figure 1). The diagnostic value was confirmed in the subgroup of patients without wall motion abnormalities for TLS and for TCS, except for RCA. Conclusion Territorial strain assessed with STE might be a non-invasive tool to localize coronary artery stenosis in patients with NSTE-ACS, even without wall motion abnormalities. FUNDunding Acknowledgement Type of funding sources: None. Figure 1. ROC curve analyses

Sign in / Sign up

Export Citation Format

Share Document