Temporal shifts in clinical presentation and underlying mechanisms of atherosclerotic disease

DSpace/Manakin Repository

Temporal shifts in clinical presentation and underlying mechanisms of atherosclerotic disease

Citable link to this page

 

 
Title: Temporal shifts in clinical presentation and underlying mechanisms of atherosclerotic disease
Author: Pasterkamp, Gerard; den Ruijter, Hester M.; Libby, Peter

Note: Order does not necessarily reflect citation order of authors.

Citation: Pasterkamp, Gerard, Hester M. den Ruijter, and Peter Libby. 2016. “Temporal Shifts in Clinical Presentation and Underlying Mechanisms of Atherosclerotic Disease.” Nature Reviews Cardiology 14 (1) (October 20): 21–29. doi:10.1038/nrcardio.2016.166.
Full Text & Related Files:
Abstract: The concept of the 'vulnerable plaque' originated from pathological observations in patients who died from acute coronary syndrome. This recognition spawned a generation of research that led to greater understanding of how complicated atherosclerotic plaques form and precipitate thrombotic events. In current practice, an increasing number of patients who survive their first event present with non-ST-segment elevation myocardial infarction (NSTEMI) rather than myocardial infarction (MI) with ST-segment elevation (STEMI). The culprit lesions that provide the pathological substrate for NSTEMI can vary considerably from the so-called 'vulnerable plaque'. The shift in clinical presentation of MI and stroke corresponds temporally to a progressive change in the characteristics of human plaques away from the supposed characteristics of vulnerability. These alterations in the structure and function of human atherosclerotic lesions might mirror the modifications that are produced in experimental plaques by lipid lowering, inspired by the vulnerable plaque construct. The shift in the clinical presentations of the acute coronary syndromes mandates a critical reassessment of the underlying mechanisms, proposed risk scores, the results and interpretation of preclinical experiments, as well as recognition of the limitations of the use of population data and samples collected before the application of current preventive interventions.
Published Version: 10.1038/nrcardio.2016.166
Terms of Use: This article is made available under the terms and conditions applicable to Open Access Policy Articles, as set forth at http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#OAP
Citable link to this page: http://nrs.harvard.edu/urn-3:HUL.InstRepos:29694793
Downloads of this work:

Show full Dublin Core record

This item appears in the following Collection(s)

 
 

Search DASH


Advanced Search
 
 

Submitters