[Is regression of atherosclerotic plaque possible?]
As it is well-known, a thrombus evolving into a disrupted/eroded atherosclerotic plaque causes most acute coronary syndromes. Plaque stabilization via reduction of the lipid core and/or thickening of the fibrous cap is one of the possible mechanisms accounted for the clinical benefits displayed by different anti-atherosclerotic strategies. The concept of plaque stabilization was developed to explain how lipid-lowering agents could decrease adverse coronary events without substantial modifications of the atherosclerotic lesion ('angiographic paradox'). A number of imaging modalities (vascular ultrasound and virtual histology, MRI, optical coherence tomography, positron tomography, etc.) are used for non-invasive assessment of atherosclerosis; most of them can identify plaque volume and composition beyond lumen stenosis. An 'aggressive' lipid-lowering strategy is able to reduce the plaque burden and the incidence of cardiovascular events; this may be attributable, at least in part, to plaque-stabilizing effects.
Servicio de Hematología, Laboratorio de Aterotrombosis, Clínica Universidad de Navarra, Pamplona, España. Electronic address: japaramo@unav.es.
José A
JA
Páramo
Unidad Clínica y de Investigación en Lípidos y Arteriosclerosis, Servicio de Medicina Interna, Hospital Universitario Miguel Servet, IIS Aragón, Zaragoza, España.
Fernando
F
Civeira
D054058:Acute Coronary Syndrome / Q000517:prevention & control*; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging / Q000379:methods; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D049268:Positron-Emission Tomography / Q000379:methods; D041623:Tomography, Optical Coherence / Q000379:methods
D000960:Hypolipidemic Agents
Aterosclerosis; Atherosclerosis; Estabilización de la placa; Hipolipemiantes; Lipid-lowering therapy; Non-invasive assessment of atherosclerosis; Plaque stabilization; Técnicas no invasivas de imagen vascular