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Current issues of the diagnosis and treatment of unstable coronary atherosclerotic plaque

Authors: M.Yu. Kaputin, A.V. Biryukov, A.A. Medvedev

Company: Pavlov First Saint Petersburg State Medical University, L'va Tolstogo ul., 6–8, St. Petersburg, 197022, Russian Federation


DOI: https://doi.org/10.15275/kreatkard.2015.04.04

For citation: Kaputin MYu, Biryukov AV, Medvedev AA. Current issues of the diagnosis and treatment of unstable coronary atherosclerotic plaque. Kreativnaya Kardiologiya. 2015; 4: 34-39 (in Russian)

Keywords: bioresorbable scaffold coronary stenting vulnerable plaque local intracoronary therapy

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Abstract

The article provides an overview of contemporary possibilities of noninvasive and invasive diagnostics of coronary plaque structure, as well as alternative methods of ndovascular treatment of vulnerable plaques; criticized current practice of coronary stenting, as well as proposed a new approach to the treatment of vulnerable plaques based on local intracoronary therapy.

References

  1. Ford E.S., Ajani U.A., Croft J.B. et al. Explaining the decrease in U.S. deaths from coronary disease, 1980–2000. N. Engl. J. Med. 2007; 356 (23): 2388–98.

  2. Go A.S., Mozaffarian D., Roger V.L. et al. Heart disease and stroke statistics – 2014 update: a report from the American Heart Association. Circulation. 2014; 129 (3): e28–e292.

  3. Libby P. Mechanisms of acute coronary syndromes and their implications for therapy. N. Engl. J. Med. 2013; 368 (21): 2004–13.

  4. Nabel E.G., Braunwald E. A tale of coronary artery disease and myocardial infarction. N. Engl. J. Med. 2012; 366 (10): 54–63.

  5. Stone G.W., Mehran R., Dangas G. et al. Differential impact on survival of electrocardiographic Q-wave versus enzymatic myocardial infarction after percutaneous intervention. Circulation. 2001; 104 (6): 642–7.

  6. Lindsey J.B., Kennedy K.F., Stolker J.M. et al. Prognostic implications of creatine kinase-MB elevation after percutaneous coronary intervention: Results from the evaluation of drug-eluting stents and ischemic events (EVENT) registry. Circ. Cardiovasc. Interv. 2011; 4 (5): 474–80.

  7. Moussa I.D., Klein L.W., Shah B. et al. Consideration of a new definition of clinically relevant myocardial infarction after coronary revascularization: an expert consensus document from the Society for Cardiovascular Angiography and Interventions (SCAI). J. Am. Coll. Cardiol. 2013; 62, (17): 1563–70.

  8. White H. Avatar of the universal definition of periprocedural myocardial infarction. J. Am. Coll. Cardiol. 2013; 62 (17): 1571–4.

  9. Burke A.P., Farb A., Malcom G.T. et al. Coronary risk factors and plaque morphology in men with coronary disease who died suddenly. N. Engl. J. Med. 1997; 336 (18): 1276–82.

  10. Falk E., Nakano M., Bentzon J.F. et al. Update on acute coronary syndromes: the pathologists' view. Eur. Heart J. 2013; 34 (10): 719–28.

  11. Virmani R., Kolodgie F.D., Burke A.P. et al. Lessons from sudden coronary death: a comprehensive morphological classification scheme for atherosclerotic lesions. Arterioscler. Thromb. Vasc. Biol. 2000; 20 (5): 1262–75.

  12. Narula J., Garg P., Achenbach S. et al. Arithmetic of vulnerable plaques for noninvasive imaging. Nat. Clin. Pract. Cardiovasc. Med. 2008; 5 (Suppl. 2): S2–10.

  13. Finn A.V., Nakano M., Narula J. et al. Concept of vulnerable/unstable plaque. Arterioscler. Thromb. Vasc. Biol. 2010; 30 (7): 1282–92.

  14. Van der Giessen A.G., Toepker M.H., Donelly P.M. et al. Reproducibility, accuracy, and predictors of accuracy for the detection of coronary atherosclerotic plaque composition by computed tomography: an ex vivo comparison to intravascular ultrasound. Invest. Radiol. 2010; 45 (11): 693–701.

  15. Heidenreich P.A., Albert N.M., Allen L.A. et al. Forecasting the impact of heart failure in the United States: a policy statement from the American Heart Association. Circ. Heart Fail. 2013; 6 (3): 606–19.

  16. Virmani R., Burke A.P., Farb A. et al. Pathology of the vulnerable plaque. J. Am. Coll. Cardiol. 2006; 47 (Suppl. 8): С13–8.

  17. Kim H.J., Vignon-Clementel I.E., Coogan J.S. et al. Patient-specific modeling of blood flow and pressure in human coronary arteries. Ann. Biomed. Eng. 2010; 38 (10): 3195–209.

  18. Chatzizisis Y.S., Coskun A.U., Jonas M. et al. Role of endothelial shear stress in the natural history of coronary atherosclerosis and vascular remodeling: molecular, cellular, and vascular behavior. J. Am. Coll. Cardiol. 2007; 49 (25): 2379–93.

  19. Stone G.W., Maehara A., Lansky A.J. et al. A prospective natural-history study of coronary atherosclerosis. N. Engl. J. Med. 2011; 364 (3): 226–35.

  20. Tian J., Dauerman H., Toma C. et al. Prevalence and characteristics of TCFA and degree of coronary artery stenosis: an OCT, IVUS, and angiographic study. Am. Coll. Cardiol. 2014; 64 (7): 672–80.

  21. Stone G.W., Abizaid A., Silber S. et al. Prospective, Randomized, Multicenter Evaluation of a Polyethylene Terephthalate Micronet Mesh-Covered Stent (MGuard) in ST-Segment Elevation Myocardial Infarction: The MASTER Trial. J. Am. Coll. Cardiol. 2012; 60 (19): 1975–84.

  22. Fernández-Cisnal A., Cid-Álvarez B., Álvarez-Álvarez B. et al. Real world comparison of the MGuard Stent versus the bare metal stent for ST elevation myocardial infarction (the REWARD-MI study). Catheter. Cardiovasc. Interv. 2015; 85 (1): E1–9.

  23. Alexy R.D., Levi D.S. Materials and manufacturing technologies available for production of a pediatric bioabsorbable stent. Biomed. Res. Int. 2013; Article ID 137985: 11.

  24. Serruys P.W., Emanuelsson H., van der Giessen W. et al. Heparin-coated Palmaz-Schatz stents in human coronary arteries. Early outcome of the Benestent-II Pilot Study. Circulation. 1996; 93 (3): 412–22.

  25. Jabara R., Chronos N., Robinson K. Novel bioabsorbable salicylate-based polymer as a drug-eluting stent coating. Catheter. Cardiovasc. Interv. 2008; 72 (2): 186–94.

  26. Ribichini F., Tomai F., Ferrero V. et al. Immunosuppressive oral prednisone after percutaneous interventions in patients with multi-vessel coronary artery disease. The IMPRESS-2/MVD study. EuroIntervention. 2005; 1: 173–80.

  27. Ferrero V., Tomai F., Versaci F. et al. Long-term results of immunosuppressive oral prednisone after coronary angioplasty in non-diabetic patients with elevated Creactive protein levels. EuroIntervention. 2009; 5: 250–4.

  28. Owens C.D., Gasper W.J., Walker J.P. et al. Safety and feasibility of adjunctive dexamethasone infusion into the adventitia of the femoropopliteal artery following endovascular revascularization. J. Vasc. Surg. 2014; 59 (4): 1016–24.

  29. Park Y.M., Han S.H., Lee K. et al. Dexamethasoneeluting stents had sustained favorable ischemic driven target lesion revascularization rates over 5 years: a randomized controlled prospective study. Int. J. Cardiol. 2013; 165 (2): 359–62.

  30. Pesarini G., Ferrero V., Tomai F. et al. Steroid-eluting stents in patients with acute coronary syndromes. Angiographic results of DESIRE: Dexamethasone-Eluting Stent Italian Registry. J. Invasive Cardiol. 2009; 21 (3): 86–91.

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


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