The DOI matches its Crossref record; 12 of the 12 references it cites were found in a registry or an index.
Acute Coronary Syndromes: The Way Forward From Mechanisms to Precision Treatment
Open accessAbstract
Well into the 21st century, we still triage acute myocardial infarction on the basis of the presence or absence of ST-segment elevation, a century-old technology. Meanwhile, we have learned a great deal about the pathophysiology and mechanisms of acute coronary syndromes (ACS) at the clinical, pathological, cellular, and molecular levels. Contemporary imaging studies have shed new light on the mechanisms of ACS. This review discusses these advances and their implications for clinical management of the ACS for the future. Plaque rupture has dominated our thinking about ACS pathophysiology for decades. However, current evidence suggests that a sole focus on plaque rupture vastly oversimplifies this complex collection of diseases and obscures other mechanisms that may mandate different management strategies. We propose segmenting coronary artery thrombosis caused by plaque rupture into cases with or without signs of concomitant inflammation. This distinction may have substantial therapeutic implications as direct anti-inflammatory interventions for atherosclerosis emerge. Coronary artery thrombosis caused by plaque erosion may be on the rise in an era of intense lipid lowering. Identification of patients with of ACS resulting from erosion may permit a less invasive approach to management than the current standard of care. We also now recognize ACS that occur without apparent epicardial coronary artery thrombus or stenosis. Such events may arise from spasm, microvascular disease, or other pathways. Emerging management strategies may likewise apply selectively to this category of ACS. We advocate this more mechanistic approach to the categorization of ACS to provide a framework for future tailoring, triage, and therapy for patients in a more personalized and precise manner.
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Cites
Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease
Ridker, P. M., Everett, B. M., Thuren, T., MacFadyen, J. G., Chang, W. H., Ballantyne, C., Fonseca, F., Nicolau, J., Koenig, W., Anker, S. D., et al. (2017) · New England Journal of Medicine · doi:10.1056/nejmoa1707914 · Cited by 9,482
Self-citationInflammation and Atherosclerosis
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Self-citationNLRP3 inflammasomes are required for atherogenesis and activated by cholesterol crystals
Duewell, P., Kono, H., Rayner, K. J., Sirois, C. M., Vladimer, G., Bauernfeind, F. G., Abela, G. S., Franchi, L., Nuñez, G., Schnurr, M., et al. (2010) · Nature · doi:10.1038/nature08938 · Cited by 4,026
Clinical Features and Outcomes of Takotsubo (Stress) Cardiomyopathy
Templin, C., Ghadri, J. R., Diekmann, J., Napp, L. C., Bataiosu, D. R., Jaguszewski, M., Cammann, V. L., Sarcon, A., Geyer, V., Neumann, C. A., et al. (2015) · New England Journal of Medicine · doi:10.1056/nejmoa1406761 · Cited by 2,595
Self-citationMechanisms of plaque formation and rupture
Bentzon, J. F., Otsuka, F., Virmani, R., & Falk, E. (2014) · Circulation Research · doi:10.1161/circresaha.114.302721 · Cited by 2,391
Thrombosis and Acute Coronary-Artery Lesions in Sudden Cardiac Ischemic Death
Davies, M. J., & Thomas, A. (1984) · New England Journal of Medicine · doi:10.1056/nejm198405033101801 · Cited by 1,694
Mechanisms of Acute Coronary Syndromes and Their Implications for Therapy
Libby, P. (2013) · New England Journal of Medicine · doi:10.1056/nejmra1216063 · Cited by 1,262
Self-citationEffects of anacetrapib in patients with atherosclerotic vascular disease
The HPS3/TIMI55–REVEAL Collaborative Group (2017) · New England Journal of Medicine · doi:10.1056/nejmoa1706444 · Cited by 1,047
Ridker, P. M., Thuren, T., Zalewski, A., & Libby, P. (2011) · American Heart Journal · doi:10.1016/j.ahj.2011.06.012 · Cited by 799
Self-citationYahagi, K., Kolodgie, F. D., Lutter, C., Mori, H., Romero, M. E., Finn, A. V., & Virmani, R. (2017) · Arteriosclerosis, Thrombosis, and Vascular Biology · doi:10.1161/atvbaha.116.306256 · Cited by 573
Cited by
The changing landscape of atherosclerosis
Libby, P. (2021) · Nature · doi:10.1038/s41586-021-03392-8 · Cited by 2,873
Self-citationInflammasome, pyroptosis, and cytokines in myocardial ischemia-reperfusion injury
Toldo, S., Mauro, A. G., Cutter, Z., & Abbate, A. (2018) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00158.2018 · Cited by 369
Inflammation in acute myocardial infarction: the good, the bad and the ugly
Matter, M. A., Paneni, F., Libby, P., Frantz, S., Stähli, B. E., Templin, C., Mengozzi, A., Wang, Y.-J., Kündig, T. M., Räber, L., et al. (2024) · European Heart Journal · doi:10.1093/eurheartj/ehad486 · Cited by 357
Self-citationFolco, E. J., Mawson, T. L., Vromman, A., Bernardes-Souza, B., Franck, G., Persson, O., Nakamura, M., Newton, G., Luscinskas, F. W., & Libby, P. (2018) · Arteriosclerosis, Thrombosis, and Vascular Biology · doi:10.1161/atvbaha.118.311150 · Cited by 341
Self-citationDziedzic, E. A., Gąsior, J. S., Tuzimek, A., Paleczny, J., Junka, A., Dąbrowski, M., & Jankowski, P. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms23179553 · Cited by 319
Metadata
- Authors
- Crea, F., & Libby, P.
- Venue
- Circulation
- Published
- 2017-09-19
- Volume
- 136
- Issue
- 12
- Pages
- 1155-1166
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2754330582
- Cited by
- 476
- References
- 12
- FWCI
- 25.91
- Type
- journal article
- Language
- en
- Open access
- green
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