Читать книгу Interventional Cardiology - Группа авторов - Страница 46

Atherosclerosis is now recognized as a diffuse, and chronic inflammatory disorder involving vascular, metabolic, and immune system with various local and systemic manifestations. A composite vulnerability index score comprising the total burden of atherosclerosis and vulnerable plaques in the coronary, carotid, aorta, and femoral arteries, together with blood vulnerability factors, should be the ideal method of risk stratification. Obviously, such index is hard to achieve with today’s tools. A future challenge is to identify patients at high risk of acute vascular events before clinical syndromes develop. At present, aside from imaging modalities such as IVUS‐ virtual histology, magnetic resonance, and local Raman spectroscopy that could help to identify vulnerable plaques, highly sensitive inflammatory circulating markers such as hsCRP, cytokines, pregnancy‐associated plasma protein‐A, pentraxin‐3, LpPLA2 are currently the best candidates for diffuse active plaque detection. In order to achieve this aim, a coordinate effort is needed to promote the application of the most promising tools and to develop new screening and diagnostic techniques to identify the vulnerable patient.