New and emerging risk factors for CVD

Area of Science:

• Cardiovascular research
• Immunology
• Pathology

Background:

• Atherogenesis involves complex processes, with plaque instability and inflammation playing key roles in clinical complications like acute coronary syndrome.
• Immune cells and auto-antibodies against modified LDL and heat-shock proteins are present in atherosclerotic lesions and blood of affected individuals.
• Current risk assessment tools, like the Framingham coronary risk score, inadequately identify moderate-risk individuals and are less useful for young adults and non-Caucasian populations.

Purpose of the Study:

• To investigate the role of inflammation in atherosclerosis and identify biomarkers for early disease detection and plaque instability.
• To evaluate the effectiveness of existing risk assessment algorithms and explore novel approaches for improved cardiovascular risk stratification.

Main Methods:

• Morphological and immunocytochemical studies of atherosclerotic lesions.
• Detection of immune cells and auto-antibodies in patient blood and lesions.
• Analysis of classical risk factors and novel biomarkers using risk engines and receiver operator characteristic curve analysis.

Main Results:

• Inflammation is a critical factor in atherogenesis and clinical complications.
• Classical risk factors in current algorithms do not sufficiently differentiate moderate-risk individuals.
• Individually identified biomarkers have not substantially improved risk prediction when incorporated into existing risk engines.

Conclusions:

• Understanding the inflammatory processes in atherosclerosis is crucial for managing cardiovascular disease.
• Novel biomarkers and risk assessment strategies are needed to improve cardiovascular risk prediction, especially in underrepresented populations.
• Emerging imaging and functional vascular assessments show promise for future clinical applications in atherosclerosis management.