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Title: Physiological Predictors of Acute Coronary Syndromes: Emerging Insights From the Plaque to the Vulnerable Patient
Authors: Ford, Tom ;Berry, C.;De Bruyne, B.;Yong, A.S.C;Barlis, P.;Fearon, W.F.;Ng, M.K.C.
Affliation: Central Coast Local Health District
Gosford Hospital
Issue Date: Dec-2017
Source: 10(24):2539-2547
Journal title: JACC Cardiovascular Interventions
Department: Cardiology
Abstract: In this review, the authors explore the evolving evidence linking physiological assessment of coronary artery disease with plaque progression and vulnerability. Reducing adverse clinical events remains the ultimate goal for diagnostic tests, and this review highlights evidence supporting the prognostic value of physiological metrics in predicting outcomes. Historical and contemporary studies support synergy among lesion severity, ischemia, plaque vulnerability, and patient prognosis. Ischemia contributes to clinical events through association with plaque burden, but this review addresses the emerging concept that it associates with atherothrombosis via disturbed lesion hemodynamics. Biomechanical pathophysiological forces including endothelial shear stress-the frictional force generated by blood flow on the vessel wall-are increasingly linked with atherogenesis, vulnerable plaque morphology, and platelet and leukocyte activation. The authors conclude by transitioning from the model of the vulnerable plaque to the concept of the "vulnerable patient," looking more broadly at physiological contributors to Virchow's triad underpinning acute coronary syndrome.
DOI: 10.1016/j.jcin.2017.08.059
ISSN: 1936-8798
Publicaton type: Journal Article
Keywords: Cardiology
Cardiovascular Disease
Heart Disease
Study or Trial: Reviews/Systematic Reviews
Appears in Collections:Cardiology

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