Combining metabolomics and OCT to reveal plasma metabolic profiling and biomarkers of plaque erosion and plaque rupture in STEMI patients

Luo, Xing; Liu, Minghao; Wang, Shengfang; Chen, Yuwu; Bao, Xiaoyi; Lv, Ying; Zhang, Shan; Xu, Biyi; Weng, Xiuzhu; Bai, Xiaoxuan; Zeng, Ming; Zhao, Chen; Li, Jihong; Jia, Haibo; Yu, Bo

doi:10.1016/j.ijcard.2023.131223

Cited by 1 publication

(2 citation statements)

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Section: Diagnostic Approach Toward Plaque Erosionmentioning

confidence: 99%

“…Moving to other less studied markers, in the study of Luo et al in 123 patients with STEMI, increased salicylic acid was associated with PE presence [ 55 ]. However, we should note the mediocre area under the receiver operating characteristic (<0.8) [ 55 ]. Given that thrombi in eroded plaques are white, consisting of highly activated platelets, this finding may indicate the existence of disordered salicylic acid metabolism and consequent platelet hyperactivity.…”

Section: Diagnostic Approach Toward Plaque Erosionmentioning

confidence: 99%

See 1 more Smart Citation

Coronary Plaque Erosion: Epidemiology, Diagnosis, and Treatment

Theofilis,

Vlachakis,

Papanikolaou

et al. 2024

IJMS

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Plaque erosion (PE), a distinct etiology of acute coronary syndromes (ACSs), is often overshadowed by plaque ruptures (PRs). Concerning its epidemiology, PE has garnered increasing recognition, with recent studies revealing its prevalence to be approximately 40% among ACS patients, challenging earlier assumptions based on autopsy data. Notably, PE exhibits distinct epidemiological features, preferentially affecting younger demographics, particularly women, and often manifesting as a non-ST-segment elevation myocardial infarction. There are seasonal variations, with PE events being less common in winter, potentially linked to physiological changes and cholesterol solidification, while peaking in summer, warranting further investigation. Moving to molecular mechanisms, PE presents a unique profile characterized by a lesser degree of inflammation compared to PR, with endothelial shear stress emerging as a plausible molecular mechanism. Neutrophil activation, toll-like receptor-2 pathways, and hyaluronidase 2 expression are among the factors implicated in PE pathophysiology, underscoring its multifactorial nature. Advancements in intravascular imaging diagnostics, particularly optical coherence tomography and near-infrared spectroscopy coupled with intravascular ultrasound, offer unprecedented insights into plaque composition and morphology. Artificial intelligence algorithms show promise in enhancing diagnostic accuracy and streamlining image interpretation, augmenting clinician decision-making. Therapeutically, the management of PE evolves, with studies exploring less invasive approaches such as antithrombotic therapy without stenting, particularly in cases identified early through intravascular imaging. Additionally, the potential role of drug-coated balloons in reducing thrombus burden and minimizing future major adverse cardiovascular events warrants further investigation. Looking ahead, the integration of advanced imaging modalities, biomarkers, and artificial intelligence promises to revolutionize the diagnosis and treatment of coronary PE, ushering in a new era of personalized and precise cardiovascular care.

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Section: Diagnostic Approach Toward Plaque Erosionmentioning

confidence: 99%

Section: Diagnostic Approach Toward Plaque Erosionmentioning

confidence: 99%