Atherosclerosis and inflammation

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.

Inflammation in Atherosclerosis and Implications for Therapy

“…Oxidized LDL is one hypothetical risk factor for atherosclerotic inflammation. 5 It is believed that oxidation of LDL may be modulated by nitric oxide (NO) and its products, as well as by myeloperoxidase and ceruloplasmin. 6,7 In one study, levels of oxidized LDL were significantly higher in patients with acute MI than in patients with angina or in controls, although lipid profiles did not differ among these groups.…”

Role of Ultrasonic Shear Rate Estimation Errors in Assessing Inflammatory Response and Vascular Risk

“…Atherosclerosis is an inflammatory disease of the arterial wall that originates preferentially in regions of branching and curvature where the time-averaged wall shear stress (WSS) is lower than 0.4 Pa (Nerem, 1992;Farmer and Torre-Amione, 2002). WSS is defined as the product of blood viscosity and wall shear rate (WSR), the radial velocity gradient measured at the vessel wall.…”

C-reactive protein levels do not correlate with retinal artery occlusion but with atherosclerosis

“…This observation is in agreement with the literature. 24,44 Previous studies have attributed increased levels of CRP to the underlying inflammatory process in atherosclerosis, 3,5,16,[45][46][47] ischaemic events, such as myocardial infarct, [13][14][15][16][17][18]26 and cerebrovascular accident. 16,19,23 We focused on another atherosclerotic complication, RAO, a devastating cause of blindness.…”

“…The assumption that inflammation plays a pathogenetic role in atherosclerosis [1][2][3][4][5] is supported by the similar histological features of the two conditions. 1,2 The earliest lesion in the arterial wall, the fatty streak, consists of monocyte-derived macrophages and T lymphocytes.…”

“…10,11 CRP levels rise within hours of a peripheral insult, such as infection or physical injury, and decrease as rapidly with resolution of the condition. 12 Elevated levels of serum CRP have been associated with ischaemic arterial diseases, 5,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] acute myocardial infarction, [13][14][15][16]18,20,29 and a premyocardial infarction state in apparently healthy people. 16,25 They may also serve as a prognostic indicator in patients with stable or unstable angina.…”