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- W2021254865 abstract "Epidemiological studies have demonstrated the difficulty of identifying individuals at risk using conventional risk factors.Although high-risk populations can be identified, the majority of individuals at risk remain in the very large low-risk populations. The emergence of new risk factors, such as homocysteine, has produced a relatively small improvement.Cardiovascular clinical endpoints are the result of several pathological events, often a series of events (atherosclerotic plaque formation, plaque instability and rupture, thrombosis) produced by different pathophysiological mechanisms.Angiography has for a long time been the means of confirming the presence and progression of atherosclerosis; also identifying plaque rupture and thrombosis as the mechanism of acute coronary syndromes.More recently, high-resolution ultrasound has been used to study asymptomatic individuals and populations and has been successful in identifying highrisk populations, individuals with rapid progression and even re-stenosis following peripheral angioplasty.A large number of gene polymorphisms have recently been shown to be associated with premature atherosclerosis, increased intima media thickness (IMT), early plaque, myocardial infarction (MI) and stroke. Genes studied include ACE, apolipoprotein E, PAI-1, factor V Leiden, prothrombin, PAF-AH, CETP, factor XIII, fibrinogen, MTHFR, apolipoprotein A-1, GpIIIa and PON1. The literature is large and ‘undigestible’, based mainly on casecontrol studies and clinical endpoints.However, we are now in a unique position to have populations available not only for case-control studies, but also for studies on the natural history of the disease and to test various hypotheses on the combination genotypes, gene expression and environmental factors on subclinical endpoints. The use of ultrasound will enable us to pose appropriate questions relating to early plaque formation, progression and stability rather than the clinical endpoint." @default.
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- W2021254865 date "2000-01-01" @default.
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- W2021254865 title "Epidemiology, Ultrasound and Molecular Biology in Atherosclerosis – Can We Bridge the Gaps?" @default.
- W2021254865 doi "https://doi.org/10.1185/0300799009117031" @default.
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