Coronary Artery Disease: from Atherosclerosis to Cardiogenic Shock
Coronairlijden: van atherosclerose tot cardiogene shock
The aim of this thesis is twofold: 1. to investigate the prognostic value of intracoronary imaging and blood biomarkers in patients with coronary artery disease; 2. to improve risk prediction and management of patients with cardiogenic shock from acute myocardial infarction. We concluded that intracoronary imaging of atherosclerosis using intravascular ultrasound virtual histology and near-infrared spectroscopy can predict cardiovascular outcome in patients with established coronary artery disease. Blood biomarkers of inflammation, unfavorable lipid profile, elevated coagulation and myocardial necrosis are associated with high-risk coronary plaque characteristics. Proteomics- and lipidomics-based research carry potential to reveal novel blood biomarkers of coronary artery disease. Patients with cardiogenic shock from acute myocardial infarction have a high in-hospital mortality. It is important to search for treatment strategies that can lower mortality of such patients. The fact that survivors have a favorable long-term clinical outcome is encouraging. Intra-aortic balloon pump counterpulsation remains the method of first choice for mechanical circulatory assistance in cardiogenic shock, despite the lack of a proven survival benefit.
|Keywords||coronary artery disease, atherosclerosis, intracoronary imaging, biomarkers, cardiogenic shock|
|Promotor||H. Boersma (Eric)|
|Publisher||Erasmus University Rotterdam|
|Sponsor||The research described in this thesis was supported by a grant of the Dutch Heart Foundation (DHF-2009B091)|
Cheng, J.M. (2015, May 12). Coronary Artery Disease: from Atherosclerosis to Cardiogenic Shock. Erasmus University Rotterdam. Retrieved from http://hdl.handle.net/1765/78104