Candidate biomarkers for the detection of coronary plaque destabilization and rupture

Area of Science:

• Cardiology
• Biomarker Discovery
• Vascular Biology

Background:

• Chest pain evaluation requires better risk stratification tools.
• Current methods struggle to identify patients with vulnerable plaque before infarction.
• Understanding plaque destabilization mechanisms is crucial for early detection.

Purpose of the Study:

• To review emerging biomarkers for vulnerable plaque.
• To explore biomarkers reflecting plaque evolution and rupture.
• To assess clinical applications for risk prediction in chest pain patients.

Main Methods:

• Literature review of current research on vulnerable plaque biomarkers.
• Analysis of pathways involved in plaque destabilization (inflammation, oxidative stress, MMPs, hemodynamics).
• Identification of candidate biomarkers reflecting these processes.

Main Results:

• Vulnerable plaque is driven by lipid core expansion and cap thinning.
• Inflammation, oxidative stress, matrix metalloproteinases, and shear stress are key pathways.
• Several candidate biomarkers show potential for detecting occult plaque instability.

Conclusions:

• Emerging biomarkers offer promise for identifying high-risk patients with chest pain.
• These biomarkers could enable earlier detection of plaque rupture and improve triage.
• Further research is needed to validate these biomarkers for clinical use.