doi: 10.1161/01.CIR.0000087481.55887.C9
(Circulation. 2003;108:1772.)
© 2003 American Heart Association, Inc.
Review: Current Perspective |
From Vulnerable Plaque to Vulnerable Patient
A Call for New Definitions and Risk Assessment Strategies: Part II
From The Center for Vulnerable Plaque Research, University of Texas—Houston, The Texas Heart Institute, and President Bush Center for Cardiovascular Health, Memorial Hermann Hospital, Houston (M. Naghavi, S.W.C., S.L., M.M., A.Z., J.T.W.); The Leducq Center for Cardiovascular Research, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass (P.L., M.A.); Department of Cardiology and Institute of Experimental Clinical Research, Aarhus University, Aarhus, Denmark (E.F.); Experimental Cardiology Laboratory, Vascular Biology of the University Medical Center in Utrecht, the Netherlands (G.P.); Ohio State University (J.R.); the Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Medical Center, New York, NY (Z.F.); Cardiac Catheterization Laboratory at the VA Medical Center, University of Kentucky, Lexington (P.M.); Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass (P.H.S.); Division of Cardiology, New England Medical Center, Boston, Mass (S.W.); Department of Medicine, Section of Cardiology, Tulane University School of Medicine, New Orleans, La (P.R.); Department of Cardiovascular Pathology, Armed Forces Institute of Pathology, Washington, DC (A.B., A.F., R.V.); Department of Radiology, University of Washington, Seattle (C.Y.); Stanford University Medical Center Stanford, Calif (P.J.F.); Cardiovascular Health Research Unit, University of Washington, Seattle (D.S.S.); Department of Cardiology, Athens Medical School, Athens, Greece (C.S.); Catheterization Laboratory, Thorax Center, Erasmus University, Rotterdam, the Netherlands (C.L.d.K.); Division of Cardiology, Department of Medicine, University of Turku, Finland (K.E.J.A.); Institute of Arteriosclerosis Research and the Institute of Clinical Chemistry and Laboratory Medicine, Central Laboratory, Hospital of the University of Münster, Munich, Germany (G.A.); Department of Clinical Radiology, University of Münster, Munich, Germany (C.R.B.); Mayo Clinic Medical School, Jacksonville, Fla (J.H.C.); Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Ga (Z.S.G.); Bristol Heart Institute, Bristol University, Bristol, United Kingdom (C.J.); Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, Mass (I.-K.J.); Department of Internal Medicine II, Cardiology, University of Ulm, Ulm, Germany (W.K.); University of Kentucky, Lexington, Ky (R.A.L.); R.L. Roudebush VA Medical Center, Indianapolis, Ind (K.M.); School of Public Health, University of Texas—Houston, Houston, Texas (J.D.); Division of Cardiology, University of California Los Angeles, Los Angeles, Calif (M. Navab); Fondazione Salvatore Maugeri, University of Pavia, Pavia, Italy (S.G.P.); Department of Cardiovascular Therapeutics, Pfizer Global Research and Development, Ann Arbor Laboratories, Ann Arbor, Mich (M.D.R.); Paul Dudley White Coronary Care System at St. Agnes HealthCare, Baltimore, Md (R.B.); Center for Human Nutrition, University of Texas Health Science Center, Dallas (S.M.G.); Lenox Hill Hospital, New York, NY (R.M.); Catheterization Laboratories, Ospedale San Raffaele and Emo Centro Cuore Columbus, Milan, Italy (A.C.); Human Genetics Center, Institute of Molecular Medicine, Houston, Tex (E.B.); Department of Medicine, Baylor College of Medicine, Houston, Tex (C.B., W.I.); Minneapolis Heart Institute and Foundation, Minneapolis, Minn (R.S.S.); Division of Cardiology, University of Maryland School of Medicine, Baltimore, Md (R.V.); Karolinska Institute, Center for Molecular Medicine, Karolinska Hospital, Stockholm, Sweden (G.K.H.); Section of Cardiology, University of Chicago, Ill (D.P.F.); Vascular Physiology and Thrombosis Research Laboratory of the Atherosclerosis Research Center, Cedars-Sinai Medical Center, Los Angeles, California (S.K.); Cardiology Department, Hannover University, Hannover, Germany (H.D.); Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Ill (P.G.); UCLA School of Medicine and Cedars-Sinai Medical Center, Los Angeles, Calif (P.K.S.); Massachusetts General Hospital, Harvard Medical School and CIMIT (Center for Integration of Medicine and Innovative Technology), Boston, Mass (J.E.M.); Cardiovascular Division, Division of Preventive Medicine, Brigham and Women’s Hospital, Boston, Mass (P.M.R.); and Indiana University School of Medicine, Krannert Institute of Cardiology, Indianapolis (D.P.Z.).
Correspondence to Morteza Naghavi, MD, Association for Eradication of Heart Attack, P.O. Box 20345, Houston, TX 77225-0345. E-mail mn{at}vp.org
Atherosclerotic cardiovascular disease results in >19 million deaths annually, and coronary heart disease accounts for the majority of this toll. Despite major advances in treatment of coronary heart disease patients, a large number of victims of the disease who are apparently healthy die suddenly without prior symptoms. Available screening and diagnostic methods are insufficient to identify the victims before the event occurs. The recognition of the role of the vulnerable plaque has opened new avenues of opportunity in the field of cardiovascular medicine. This consensus document concludes the following. (1) Rupture-prone plaques are not the only vulnerable plaques. All types of atherosclerotic plaques with high likelihood of thrombotic complications and rapid progression should be considered as vulnerable plaques. We propose a classification for clinical as well as pathological evaluation of vulnerable plaques. (2) Vulnerable plaques are not the only culprit factors for the development of acute coronary syndromes, myocardial infarction, and sudden cardiac death. Vulnerable blood (prone to thrombosis) and vulnerable myocardium (prone to fatal arrhythmia) play an important role in the outcome. Therefore, the term "vulnerable patient" may be more appropriate and is proposed now for the identification of subjects with high likelihood of developing cardiac events in the near future. (3) A quantitative method for cumulative risk assessment of vulnerable patients needs to be developed that may include variables based on plaque, blood, and myocardial vulnerability. In Part I of this consensus document, we cover the new definition of vulnerable plaque and its relationship with vulnerable patients. Part II of this consensus document will focus on vulnerable blood and vulnerable myocardium and provide an outline of overall risk assessment of vulnerable patients. Parts I and II are meant to provide a general consensus and overviews the new field of vulnerable patient. Recently developed assays (eg, C-reactive protein), imaging techniques (eg, CT and MRI), noninvasive electrophysiological tests (for vulnerable myocardium), and emerging catheters (to localize and characterize vulnerable plaque) in combination with future genomic and proteomic techniques will guide us in the search for vulnerable patients. It will also lead to the development and deployment of new therapies and ultimately to reduce the incidence of acute coronary syndromes and sudden cardiac death. We encourage healthcare policy makers to promote translational research for screening and treatment of vulnerable patients.
Key Words: coronary disease • plaque • myocardial infarction • atherosclerosis • death, sudden
This article has been cited by other articles:
 |
|
 |
|
  S. A. Parikh and M. A. Costa Secondary Prevention, the Interventional Way: Prophylactic Drug-Eluting Stents for Nonobstructive Saphenous Vein Graft Disease Circulation, November 17, 2009; 120(20): 1940 - 1942. [Full Text] [PDF]
|
|
|
|
 |
|
 S. Wright, F. O'Prey, P. Hamilton, C. Lockhart, A McCann, M. McHenry, R. McGivern, R Plumb, M. Finch, A. Bell, et al. Colour Doppler ultrasound of the ocular circulation in patients with systemic lupus erythematosus identifies altered microcirculatory haemodynamics Lupus, October 1, 2009; 18(11): 950 - 957. [Abstract] [PDF]
|
|
|
|
 |
|
 A. Rominger, T. Saam, S. Wolpers, C. C. Cyran, M. Schmidt, S. Foerster, K. Nikolaou, M. F. Reiser, P. Bartenstein, and M. Hacker 18F-FDG PET/CT Identifies Patients at Risk for Future Vascular Events in an Otherwise Asymptomatic Cohort with Neoplastic Disease J. Nucl. Med., October 1, 2009; 50(10): 1611 - 1620. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Kumar and C. P. Cannon Acute Coronary Syndromes: Diagnosis and Management, Part I Mayo Clin. Proc., October 1, 2009; 84(10): 917 - 938. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V O Puntmann How-to guide on biomarkers: biomarker definitions, validation and applications with examples from cardiovascular disease Postgrad. Med. J., October 1, 2009; 85(1008): 538 - 545. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Xiong, Y.-B. Deng, Y. Zhu, Y.-N. Liu, and X.-J. Bi Correlation of Carotid Plaque Neovascularization Detected by Using Contrast-enhanced US with Clinical Symptoms Radiology, May 1, 2009; 251(2): 583 - 589. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Pellegrin, F. Alonso, J.-F. Aubert, K. Bouzourene, V. Braunersreuther, F. Mach, J.-A. Haefliger, D. Hayoz, A. Berthelot, J. Nussberger, et al. Swimming Prevents Vulnerable Atherosclerotic Plaque Development in Hypertensive 2-Kidney, 1-Clip Mice by Modulating Angiotensin II Type 1 Receptor Expression Independently From Hemodynamic Changes Hypertension, May 1, 2009; 53(5): 782 - 789. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Raichlin, J.-H. Bae, S. S. Kushwaha, R. J. Lennon, A. Prasad, C. S. Rihal, and A. Lerman Inflammatory burden of cardiac allograft coronary atherosclerotic plaque is associated with early recurrent cellular rejection and predicts a higher risk of vasculopathy progression. J. Am. Coll. Cardiol., April 14, 2009; 53(15): 1279 - 1286. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Z.-S. Shi, L. Feng, X. He, A. Ishii, J. Goldstine, H.V. Vinters, and F. Vinuela Vulnerable Plaque in a Swine Model of Carotid Atherosclerosis AJNR Am. J. Neuroradiol., March 1, 2009; 30(3): 469 - 472. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. W. Hamm, H. Möllmann, J.-P. Bassand, and F. van de Werf CHAPTER 16 Acute Coronary Syndromes ESC Textbook of Cardiovascular Medicine, January 1, 2009; 2(1): med-9780199566990-chapter - med-9780199566990-chapter. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. J. Goldberger, M. E. Cain, S. H. Hohnloser, A. H. Kadish, B. P. Knight, M. S. Lauer, B. J. Maron, R. L. Page, R. S. Passman, D. Siscovick, et al. American Heart Association/American College of Cardiology Foundation/Heart Rhythm Society Scientific Statement on Noninvasive Risk Stratification Techniques for Identifying Patients at Risk for Sudden Cardiac Death: A Scientific Statement From the American Heart Association Council on Clinical Cardiology Committee on Electrocardiography and Arrhythmias and Council on Epidemiology and Prevention J. Am. Coll. Cardiol., September 30, 2008; 52(14): 1179 - 1199. [Full Text] [PDF]
|
|
|
|
|
|
J. J. Goldberger, M. E. Cain, S. H. Hohnloser, A. H. Kadish, B. P. Knight, M. S. Lauer, B. J. Maron, R. L. Page, R. S. Passman, D. Siscovick, et al. American Heart Association/American College of Cardiology Foundation/Heart Rhythm Society Scientific Statement on Noninvasive Risk Stratification Techniques for Identifying Patients at Risk for Sudden Cardiac Death: A Scientific Statement From the American Heart Association Council on Clinical Cardiology Committee on Electrocardiography and Arrhythmias and Council on Epidemiology and Prevention Circulation, September 30, 2008; 118(14): 1497 - 1518. [Full Text] [PDF]
|
|
|
|
|
|
E.-K. Choi, S. I. Choi, J. J. Rivera, K. Nasir, S.-A. Chang, E. J. Chun, H.-K. Kim, D.-J. Choi, R. S. Blumenthal, and H.-J. Chang Coronary Computed Tomography Angiography as a Screening Tool for the Detection of Occult Coronary Artery Disease in Asymptomatic Individuals J. Am. Coll. Cardiol., July 29, 2008; 52(5): 357 - 365. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. F. Langer, R. Haubner, B. J. Pichler, and M. Gawaz Radionuclide imaging a molecular key to the atherosclerotic plaque. J. Am. Coll. Cardiol., July 1, 2008; 52(1): 1 - 12. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. L. Mega, D. A. Morrow, J. A. de Lemos, S. Mohanavelu, C. P. Cannon, and M. S. Sabatine Thrombus precursor protein and clinical outcomes in patients with acute coronary syndromes. J. Am. Coll. Cardiol., June 24, 2008; 51(25): 2422 - 2429. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. H.F. Rudd, K. S. Myers, S. Bansilal, J. Machac, C. A. Pinto, C. Tong, A. Rafique, R. Hargeaves, M. Farkouh, V. Fuster, et al. Atherosclerosis Inflammation Imaging with 18F-FDG PET: Carotid, Iliac, and Femoral Uptake Reproducibility, Quantification Methods, and Recommendations J. Nucl. Med., June 1, 2008; 49(6): 871 - 878. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. N. Redgrave, P. Gallagher, J. K. Lovett, and P. M. Rothwell Critical Cap Thickness and Rupture in Symptomatic Carotid Plaques: The Oxford Plaque Study Stroke, June 1, 2008; 39(6): 1722 - 1729. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. O. Caymaz and G. Yuksel Fate of Incidental, Asymptomatic Lesions Discovered During Percutaneous Coronary Intervention Angiology, May 1, 2008; 59(2): 193 - 197. [Abstract] [PDF]
|
|
|
|
|
|
J. Nussberger, J.-F. Aubert, K. Bouzourene, M. Pellegrin, D. Hayoz, and L. Mazzolai Renin Inhibition by Aliskiren Prevents Atherosclerosis Progression: Comparison With Irbesartan, Atenolol, and Amlodipine Hypertension, May 1, 2008; 51(5): 1306 - 1311. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D.C. Suh, J.K. Kim, J.W. Choi, B.S. Choi, H.W. Pyun, Y.J. Choi, M.-H. Kim, H.R. Yang, H.I. Ha, S.J. Kim, et al. Intracranial Stenting of Severe Symptomatic Intracranial Stenosis: Results of 100 Consecutive Patients AJNR Am. J. Neuroradiol., April 1, 2008; 29(4): 781 - 785. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Rossi, A. Nuzzo, G. Origliani, and M. G. Modena Prognostic role of flow-mediated dilation and cardiac risk factors in post-menopausal women. J. Am. Coll. Cardiol., March 11, 2008; 51(10): 997 - 1002. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Saam, H. R. Underhill, B. Chu, N. Takaya, J. Cai, N. L. Polissar, C. Yuan, and T. S. Hatsukami Prevalence of American Heart Association type VI carotid atherosclerotic lesions identified by magnetic resonance imaging for different levels of stenosis as measured by duplex ultrasound. J. Am. Coll. Cardiol., March 11, 2008; 51(10): 1014 - 1021. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. Gottlieb and J. A.C. Lima Screening High-Risk Patients With Computed Tomography Angiography Circulation, March 11, 2008; 117(10): 1318 - 1332. [Full Text] [PDF]
|
|
|
|
|
|
A. Fougerat, S. Gayral, P. Gourdy, A. Schambourg, T. Ruckle, M. K. Schwarz, C. Rommel, E. Hirsch, J.-F. Arnal, J.-P. Salles, et al. Genetic and Pharmacological Targeting of Phosphoinositide 3-Kinase-{gamma} Reduces Atherosclerosis and Favors Plaque Stability by Modulating Inflammatory Processes Circulation, March 11, 2008; 117(10): 1310 - 1317. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. V. Raman, M. W. Winner III, T. Tran, M. Velayutham, O. P. Simonetti, P. B. Baker, J. Olesik, B. McCarthy, A. K. Ferketich, and J. L. Zweier In vivo atherosclerotic plaque characterization using magnetic susceptibility distinguishes symptom-producing plaques. J. Am. Coll. Cardiol. Img., January 1, 2008; 1(1): 49 - 57. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. R. S. Packard and P. Libby Inflammation in Atherosclerosis: From Vascular Biology to Biomarker Discovery and Risk Prediction Clin. Chem., January 1, 2008; 54(1): 24 - 38. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. F. Padera Jr. and F. J. Schoen Pathology of Cardiac Surgery Card. Surg. Adult, January 1, 2008; 3(2008): 111 - 178. [Full Text]
|
|
|
|
 |
|
 T. Y Tang, S. P S Howarth, S. R Miller, M. J Graves, J.-M. U-King-Im, R. A Trivedi, Z. Y. Li, S. R Walsh, A. P Brown, P. J Kirkpatrick, et al. Comparison of the inflammatory burden of truly asymptomatic carotid atheroma with atherosclerotic plaques contralateral to symptomatic carotid stenosis: an ultra small superparamagnetic iron oxide enhanced magnetic resonance study J. Neurol. Neurosurg. Psychiatry, December 1, 2007; 78(12): 1337 - 1343. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Shah, P. Balan, M. Weinberg, V. Reddy, R. Neems, M. Feinstein, J. Dainauskas, P. Meyer, M. Goldin, and S. B. Feinstein Contrast-enhanced ultrasound imaging of atherosclerotic carotid plaque neovascularization: a new surrogate marker of atherosclerosis? Vascular Medicine, November 1, 2007; 12(4): 291 - 297. [Abstract] [PDF]
|
|
|
|
|
|
L. G. Spagnoli, E. Bonanno, G. Sangiorgi, and A. Mauriello Role of Inflammation in Atherosclerosis J. Nucl. Med., November 1, 2007; 48(11): 1800 - 1815. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. A Blumenthal, A. Sherwood, S. D. Rogers, M. A. Babyak, P. Murali Doraiswamy, L. Watkins, B. M. Hoffman, C. O'Connell, J. J. Johnson, S. M. Patidar, et al. Understanding prognostic benefits of exercise and antidepressant therapy for persons with depression and heart disease: the UPBEAT study rationale, design, and methodological issues Clinical Trials, October 1, 2007; 4(5): 548 - 559. [Abstract] [PDF]
|
|
|
|
 |
|
 A. Angelini, M. Della Barbera, and G. Thiene Interventional procedures for atherothrombosis: pathology of retrieved material Heart, October 1, 2007; 93(10): 1301 - 1308. [Full Text] [PDF]
|
|
|
|
|
|
C. Ebeling Barbier, T. Bjerner, T. Hansen, J. Andersson, L. Lind, J. Hulthe, L. Johansson, and H. Ahlstrom Clinically Unrecognized Myocardial Infarction Detected at MR Imaging May Not Be Associated with Atherosclerosis Radiology, October 1, 2007; 245(1): 103 - 110. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. L. Anderson, C. D. Adams, E. M. Antman, C. R. Bridges, R. M. Califf, D. E. Casey Jr, W. E. Chavey II, F. M. Fesmire, J. S. Hochman, T. N. Levin, et al. ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction) Developed in Collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine J. Am. Coll. Cardiol., August 14, 2007; 50(7): e1 - e157. [Full Text] [PDF]
|
|
|
|
|
|
S. Motoyama, T. Kondo, M. Sarai, A. Sugiura, H. Harigaya, T. Sato, K. Inoue, M. Okumura, J. Ishii, H. Anno, et al. Multislice Computed Tomographic Characteristics of Coronary Lesions in Acute Coronary Syndromes J. Am. Coll. Cardiol., July 24, 2007; 50(4): 319 - 326. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Authors/Task Force Members, J.-P. Bassand, C. W. Hamm, D. Ardissino, E. Boersma, A. Budaj, F. Fernandez-Aviles, K. A.A. Fox, D. Hasdai, E. M. Ohman, et al. Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes: The Task Force for the Diagnosis and Treatment of Non-ST-Segment Elevation Acute Coronary Syndromes of the European Society of Cardiology Eur. Heart J., July 1, 2007; 28(13): 1598 - 1660. [Full Text] [PDF]
|
|
|
|
|
|
T. Saam, T. S. Hatsukami, N. Takaya, B. Chu, H. Underhill, W. S. Kerwin, J. Cai, M. S. Ferguson, and C. Yuan The Vulnerable, or High-Risk, Atherosclerotic Plaque: Noninvasive MR Imaging for Characterization and Assessment Radiology, July 1, 2007; 244(1): 64 - 77. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Lerman, D. R. Holmes, J. Herrmann, and B. J. Gersh Microcirculatory dysfunction in ST-elevation myocardial infarction: cause, consequence, or both? Eur. Heart J., April 1, 2007; 28(7): 788 - 797. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Peters When a Myocardial Infarction Comes Out of the Not-So-Blue Air Circulation, December 5, 2006; 114(23): 2430 - 2431. [Full Text] [PDF]
|
|
|
|
 |
|
 O. A. Iakoubova, C. H. Tong, A. P. Chokkalingam, C. M. Rowland, T. G. Kirchgessner, J. Z. Louie, L. M. Ploughman, M. S. Sabatine, H. Campos, J. J. Catanese, et al. Asp92Asn Polymorphism in the Myeloid IgA Fc Receptor Is Associated With Myocardial Infarction in Two Disparate Populations: CARE and WOSCOPS Arterioscler Thromb Vasc Biol, December 1, 2006; 26(12): 2763 - 2768. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Mor, G. Luboshits, D. Planer, G. Keren, and J. George Altered status of CD4+CD25+ regulatory T cells in patients with acute coronary syndromes Eur. Heart J., November 1, 2006; 27(21): 2530 - 2537. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Reinhardt, M. Winkler, P. Schaarschmidt, R. Pretsch, S. Zhou, B. Vaida, A. Schmid-Kotsas, D. Michel, P. Walther, M. Bachem, et al. Human cytomegalovirus-induced reduction of extracellular matrix proteins in vascular smooth muscle cell cultures: a pathomechanism in vasculopathies? J. Gen. Virol., October 1, 2006; 87(Pt 10): 2849 - 2858. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Otsuka, S. Sugiyama, S. Kojima, H. Maruyoshi, T. Funahashi, K. Matsui, T. Sakamoto, M. Yoshimura, K. Kimura, S. Umemura, et al. Plasma Adiponectin Levels Are Associated With Coronary Lesion Complexity in Men With Coronary Artery Disease J. Am. Coll. Cardiol., September 19, 2006; 48(6): 1155 - 1162. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Papaspyridonos, A. Smith, K. G. Burnand, P. Taylor, S. Padayachee, K. E. Suckling, C. H. James, D. R. Greaves, and L. Patel Novel Candidate Genes in Unstable Areas of Human Atherosclerotic Plaques Arterioscler Thromb Vasc Biol, August 1, 2006; 26(8): 1837 - 1844. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Hausleiter, T. Meyer, M. Hadamitzky, A. Kastrati, S. Martinoff, and A. Schomig Prevalence of Noncalcified Coronary Plaques by 64-Slice Computed Tomography in Patients With an Intermediate Risk for Significant Coronary Artery Disease J. Am. Coll. Cardiol., July 18, 2006; 48(2): 312 - 318. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. B. Feinstein Contrast Ultrasound Imaging of the Carotid Artery Vasa Vasorum and Atherosclerotic Plaque Neovascularization J. Am. Coll. Cardiol., July 18, 2006; 48(2): 236 - 243. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Sangiorgi, A. Mauriello, E. Bonanno, C. Oxvig, C. A. Conover, M. Christiansen, S. Trimarchi, V. Rampoldi, D. R. Holmes Jr, R. S. Schwartz, et al. Pregnancy-Associated Plasma Protein-A Is Markedly Expressed by Monocyte-Macrophage Cells in Vulnerable and Ruptured Carotid Atherosclerotic Plaques: A Link Between Inflammation and Cerebrovascular Events J. Am. Coll. Cardiol., June 6, 2006; 47(11): 2201 - 2211. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. D. MacDougall, F. Kramer, P. Polinsky, S. Barnhart, B. Askari, F. Johansson, R. Varon, M. E. Rosenfeld, K. Oka, L. Chan, et al. Aggressive Very Low-Density Lipoprotein (VLDL) and LDL Lowering by Gene Transfer of the VLDL Receptor Combined with a Low-Fat Diet Regimen Induces Regression and Reduces Macrophage Content in Advanced Atherosclerotic Lesions in LDL Receptor-Deficient Mice Am. J. Pathol., June 1, 2006; 168(6): 2064 - 2073. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. S. Vasan Biomarkers of Cardiovascular Disease: Molecular Basis and Practical Considerations Circulation, May 16, 2006; 113(19): 2335 - 2362. [Full Text] [PDF]
|
|
|
|
|
|
H. Chon, M. C. Verhaar, H. A. Koomans, J. A. Joles, and B. Braam Role of Circulating Karyocytes in the Initiation and Progression of Atherosclerosis Hypertension, May 1, 2006; 47(5): 803 - 810. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Falk Pathogenesis of atherosclerosis. J. Am. Coll. Cardiol., April 18, 2006; 47(8 Suppl): C7 - C12. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. A. Jaffer, P. Libby, and R. Weissleder Molecular and Cellular Imaging of Atherosclerosis: Emerging Applications J. Am. Coll. Cardiol., April 4, 2006; 47(7): 1328 - 1338. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Valgimigli, G. A. Rodriguez-Granillo, H. M. Garcia-Garcia, P. Malagutti, E. Regar, P. de Jaegere, P. de Feyter, and P. W. Serruys Distance from the ostium as an independent determinant of coronary plaque composition in vivo: an intravascular ultrasound study based radiofrequency data analysis in humans Eur. Heart J., March 2, 2006; 27(6): 655 - 663. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Deng, S.-p. Zhao, H.-y. Dai, X.-s. Guan, and H.-g. Huang Atorvastatin Reduces the Expression of COX-2 mRNA in Peripheral Blood Monocytes from Patients with Acute Myocardial Infarction and Modulates the Early Inflammatory Response Clin. Chem., February 1, 2006; 52(2): 300 - 303. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. A. Poole-Wilson, A. Jacques, and A. Lyon Treatment of angina: a commentary on new therapeutic approaches Eur. Heart J. Suppl., February 1, 2006; 8(suppl_A): A20 - A25. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Toutouzas, M. Drakopoulou, J. Mitropoulos, E. Tsiamis, S. Vaina, M. Vavuranakis, V. Markou, E. Bosinakou, and C. Stefanadis Elevated Plaque Temperature in Non-Culprit De Novo Atheromatous Lesions of Patients With Acute Coronary Syndromes J. Am. Coll. Cardiol., January 17, 2006; 47(2): 301 - 306. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G Parodi, G Memisha, R Valenti, M Trapani, A Migliorini, G M Santoro, and D Antoniucci Five year outcome after primary coronary intervention for acute ST elevation myocardial infarction: results from a single centre experience Heart, December 1, 2005; 91(12): 1541 - 1544. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Raggi, A. Bellasi, and C. Ratti Ischemia Imaging and Plaque Imaging in Diabetes: Complementary tools to improve cardiovascular risk management Diabetes Care, November 1, 2005; 28(11): 2787 - 2794. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Larose, Y. Yeghiazarians, P. Libby, E.K. Yucel, M. Aikawa, D. F. Kacher, E. Aikawa, S. Kinlay, F. J. Schoen, A. P. Selwyn, et al. Characterization of Human Atherosclerotic Plaques by Intravascular Magnetic Resonance Imaging Circulation, October 11, 2005; 112(15): 2324 - 2331. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Sabeti, M. Exner, W. Mlekusch, J. Amighi, P. Quehenberger, H. Rumpold, G. Maurer, E. Minar, O. Wagner, and M. Schillinger Prognostic Impact of Fibrinogen in Carotid Atherosclerosis: Nonspecific Indicator of Inflammation or Independent Predictor of Disease Progression? Stroke, July 1, 2005; 36(7): 1400 - 1404. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Libby and P. Theroux Pathophysiology of Coronary Artery Disease Circulation, June 28, 2005; 111(25): 3481 - 3488. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Mauriello, G. Sangiorgi, S. Fratoni, G. Palmieri, E. Bonanno, L. Anemona, R. S. Schwartz, and L. G. Spagnoli Diffuse and Active Inflammation Occurs in Both Vulnerable and Stable Plaques of the Entire Coronary Tree: A Histopathologic Study of Patients Dying of Acute Myocardial Infarction J. Am. Coll. Cardiol., May 17, 2005; 45(10): 1585 - 1593. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. S. Apple, A. H.B. Wu, J. Mair, J. Ravkilde, M. Panteghini, J. Tate, F. Pagani, R. H. Christenson, M. Mockel, O. Danne, et al. Future Biomarkers for Detection of Ischemia and Risk Stratification in Acute Coronary Syndrome Clin. Chem., May 1, 2005; 51(5): 810 - 824. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. K. MacCallum Markers of Hemostasis and Systemic Inflammation in Heart Disease and Atherosclerosis in Smokers Proceedings of the ATS, April 1, 2005; 2(1): 34 - 43. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. Maier, L. A. Altwegg, R. Corti, S. Gay, M. Hersberger, F. E. Maly, G. Sutsch, M. Roffi, M. Neidhart, F. R. Eberli, et al. Inflammatory Markers at the Site of Ruptured Plaque in Acute Myocardial Infarction: Locally Increased Interleukin-6 and Serum Amyloid A but Decreased C-Reactive Protein Circulation, March 22, 2005; 111(11): 1355 - 1361. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Y Stokes and D. N. Granger The microcirculation: a motor for the systemic inflammatory response and large vessel disease induced by hypercholesterolaemia? J. Physiol., February 1, 2005; 562(3): 647 - 653. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Lerman and A. M. Zeiher Endothelial Function: Cardiac Events Circulation, January 25, 2005; 111(3): 363 - 368. [Full Text] [PDF]
|
|
|
|
|
|
S Schroeder, A Kuettner, T Wojak, J Janzen, M Heuschmid, T Athanasiou, T Beck, C Burgstahler, C Herdeg, C D Claussen, et al. Non-invasive evaluation of atherosclerosis with contrast enhanced 16 slice spiral computed tomography: results of ex vivo investigations Heart, December 1, 2004; 90(12): 1471 - 1475. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. R. Veillard, S. Steffens, F. Burger, G. Pelli, and F. Mach Differential Expression Patterns of Proinflammatory and Antiinflammatory Mediators During Atherogenesis in Mice Arterioscler Thromb Vasc Biol, December 1, 2004; 24(12): 2339 - 2344. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Fleiner, M. Kummer, M. Mirlacher, G. Sauter, G. Cathomas, R. Krapf, and B. C. Biedermann Arterial Neovascularization and Inflammation in Vulnerable Patients: Early and Late Signs of Symptomatic Atherosclerosis Circulation, November 2, 2004; 110(18): 2843 - 2850. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. F. Charo and M. B. Taubman Chemokines in the Pathogenesis of Vascular Disease Circ. Res., October 29, 2004; 95(9): 858 - 866. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. G. Spagnoli, A. Mauriello, G. Sangiorgi, S. Fratoni, E. Bonanno, R. S. Schwartz, D. G. Piepgras, R. Pistolese, A. Ippoliti, and D. R. Holmes Jr Extracranial Thrombotically Active Carotid Plaque as a Risk Factor for Ischemic Stroke JAMA, October 20, 2004; 292(15): 1845 - 1852. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. F. Viles-Gonzalez, M. Poon, J. Sanz, T. Rius, K. Nikolaou, Z. A. Fayad, V. Fuster, and J. J. Badimon In Vivo 16-Slice, Multidetector-Row Computed Tomography for the Assessment of Experimental Atherosclerosis: Comparison With Magnetic Resonance Imaging and Histopathology Circulation, September 14, 2004; 110(11): 1467 - 1472. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. J. Chilton Pathophysiology of Coronary Heart Disease: A Brief Review J Am Osteopath Assoc, September 1, 2004; 104(9_suppl): 5S - 8S. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. M. Doherty, L. A. Fitzpatrick, D. Inoue, J.-H. Qiao, M. C. Fishbein, R. C. Detrano, P. K. Shah, and T. B. Rajavashisth Molecular, Endocrine, and Genetic Mechanisms of Arterial Calcification Endocr. Rev., August 1, 2004; 25(4): 629 - 672. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. C. Wang, S.-L. T. Normand, L. Mauri, and R. E. Kuntz Coronary Artery Spatial Distribution of Acute Myocardial Infarction Occlusions Circulation, July 20, 2004; 110(3): 278 - 284. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Irimia, E. Martinez-Vila, J. R. Lynch, and D. T. Laskowitz Diagnostic Test for Acute Cerebral Ischemia * Panel of Serum Markers for Rapid Diagnosis of Acute Stroke Stroke, June 1, 2004; 35(6): e140 - e141. [Full Text] [PDF]
|
|