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Atherosclerosis and inflammation
John A Farmer1, Guillermo Torre-Amione
1Section of Cardiology, Baylor College of Medicine, Ben Taub General Hospital, One Baylor Plaza, Room 525D, Houston, TX 77030, USA. jfarmer@bcm.tmc.edu
Insights
Inflammation plays a key role in coronary atherosclerosis, a complex heart disease. New clinical markers of inflammation may improve the prediction of heart disease risk beyond traditional factors.
Area of Science:
- Cardiovascular Medicine
- Immunology
- Biochemistry
Background:
- Coronary atherosclerosis is a complex, multifactorial disease.
- Traditional risk factors (hypertension, diabetes, etc.) have limitations in predicting individual patient risk.
- Atherosclerosis is increasingly recognized as an inflammatory process.
Purpose of the Study:
- To review inflammation as a potential pathogenetic factor in atherosclerosis.
- To explore the role of clinical inflammation markers in patient risk identification.
Main Methods:
- Literature review focusing on the role of inflammation in atherosclerosis.
- Analysis of emerging clinical markers of inflammation.
- Evaluation of prognostic information provided by these markers.
Main Results:
- Evidence supports inflammation's central role from early lesions to vulnerable plaques.
- Clinical markers like C-reactive protein and modified LDL show promise.
- These markers may offer additional prognostic value in managing patients.
Conclusions:
- Inflammation is a critical factor in the pathogenesis of coronary atherosclerosis.
- Clinical markers of inflammation can enhance risk stratification for cardiovascular disease.
- Further research into these markers can improve patient management and outcomes.
Abstract:
The pathophysiology of coronary atherosclerosis is complex and multifactorial. The probability of the development of symptomatic coronary heart disease may be predicted by standard risk factor stratification involving hypertension, dyslipidemia, age, positive family history, and diabetes. However, risk factor stratification has been demonstrated to have significant limitations in the individual patient, which has generated a search for more specific and sensitive markers. Evidence is increasing that atherosclerosis is a disease characterized by inflammation, beginning with the earliest identifiable lesion (fatty streak) to the advanced vulnerable plaque. Clinical markers of inflammation, including C-reactive protein, modified low-density lipoprotein, homocysteine, tumor necrosis factor, and thermogenicity, have been identified as emerging risk factors that may add prognostic information in patient management. This review centers on inflammation as a potential pathogenetic factor in atherosclerosis and the role that clinical markers may play in the identification of patients at risk.