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Antiangiogenic therapy for normalization of atherosclerotic plaque vasculature: a potential strategy for plaque stabilization
Abstract
Angiogenesis within human atherosclerotic plaques has an important role in plaque progression as immature blood vessels leak red blood cells and inflammatory mediators into the plaque center. Accumulation of free cholesterol from red blood cell membranes potentially increases the size of the necrotic core and triggers a chain of events that promote plaque destabilization. Antiangiogenic agents have been shown to prune some tumor vessels and 'normalize' the structure and function of the remaining vasculature, thereby improving the access of chemotherapeutic agents to tumors. We propose that antiangiogenic therapy can similarly stabilize vulnerable 'rupture-prone' plaques by pruning and normalizing immature intraplaque vessels, preventing further intraplaque hemorrhage. This normalization would limit necrotic core enlargement, further luminal narrowing and the degree of inflammation. Such normalization has been realized using vascular endothelial growth factor antagonists for the treatment of cancer and age-related macular degeneration. The development of this novel approach to prevent plaque progression might add to the armamentarium of preventive measures for acute myocardial infarction, stroke and sudden cardiac death.
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“Anti-angiogenic agents are another drug class currently under investigation for the stabilization of atherosclerotic plaques26,104.”
From Perspectives and opportunities for nanomedicine in the management of atherosclerosis (2011) · cites this paper as [104]
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Metadata
- Authors
- Jain, R. K., Finn, A. V., Kolodgie, F. D., Gold, H. K., & Virmani, R.
- Affiliations
- Harvard University (US)
- CVPath Institute (US)
- Corresponding author
- Jain, Rakesh K
- Gold, Herman K
- Venue
- Nature Clinical Practice Cardiovascular Medicine
- Published
- 2007-09
- Volume
- 4
- Issue
- 9
- Pages
- 491-502
- ISSN
- 1743-4297 (ISSN-L)
- 1743-4300
- OpenAlex
- W2024455227
- Cited by
- 117
- References
- 80
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2023: 1 · 2022: 3 · 2021: 1 · 2020: 1 · 2019: 3 · 2018: 8 · 2017: 6 · 2016: 3 · 2015: 9 · 2014: 9 · 2013: 10 · 2012: 14
- FWCI
- 0.83
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature Clinical Practice Cardiovascular Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Cancer Institute (P01CA080124)
- Topics
- Life Sciences › Immunology and Microbiology › Immunology › Atherosclerosis and Cardiovascular Diseases
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Coronary Interventions and Diagnostics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cerebrovascular and Carotid Artery Diseases
- Keywords
- anti-angiogenic therapy, atherosclerotic plaque, plaque stabilization, intraplaque hemorrhage, angiogenesis, vascular normalization, vulnerable plaque, necrotic core, plaque progression, acute myocardial infarction, stroke, sudden cardiac death
- MeSH terms
- Coronary Artery Disease, Coronary Vessels, Hemorrhage, Humans, Neovascularization, Pathologic, Angiogenesis Inhibitors
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