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.

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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)
ISBN 978-94-6169-650-2
Persistent URL hdl.handle.net/1765/78104
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