李楠,陈润真,颜红兵

• 1:国家心血管病中心北京协和医学院中国医学科学院阜外医院冠心病中心
• 2:中国医学科学院阜外医院深圳医院

摘要(Abstract)：

目前急性心肌梗死标准治疗以血运重建、双联抗血小板治疗和降脂治疗为核心，没有充分考虑冠状动脉罪犯斑块病理类型、斑块下微结构和全身生物学风险等因素，可能是急性心肌梗死患者标准治疗后事件发生的主要原因。因此，针对急性心肌梗死患者的精准治疗策略是临床中亟待解决的问题。近年来研究表明，体循环标志物可以帮助判别急性心肌梗死患者冠状动脉斑块特征并提高传统预后模型的准确性，有望成为识别斑块类型及实现早期风险分层的重要手段。

关键词(KeyWords)： 急性心肌梗死;循环标志物;冠状动脉斑块

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金项目（81970308）;; 深圳市医疗卫生三名工程项目（SZSM201911017）;; 深圳市医学重点学科建设经费项目（SZXK001）

作者(Author): 李楠,陈润真,颜红兵

参考文献(References)：

• [1] Scalone G, Niccoli G, Refaat H, et al. Not all plaque ruptures are born equal:an optical coherence tomography study[J]. Eur Heart J Cardiovasc Imaging, 2017, 18(11):1271-1277.
• [2] Jia H, Abtahian F, Aguirre AD, et al. In vivo diagnosis of plaque erosion and calcifi ed nodule in patients with acute coronary syndrome by intravascular optical coherence tomography[J]. J Am Coll Cardiol, 2013, 62(19):1748-1758.
• [3]陈润真，刘臣，周鹏，等.急性心肌梗死经皮冠状动脉介入治疗术后D-二聚体、高敏C反应蛋白及LDL-C水平与预后的关系[J].中华心血管病杂志，2020, 48(5):359-366.
• [4] Niccoli G, Montone RA, Di Vito L, et al. Plaque rupture and intact fi brous cap assessed by optical coherence tomography portend different outcomes in patients with acute coronary syndrome[J]. Eur Heart J, 2015, 36(22):1377-1384.
• [5] Soeda T, Higuma T, Abe N, et al. Morphological predictors for no refl ow phenomenon after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction caused by plaque rupture[J]. Eur Heart J Cardiovasc Imaging, 2017, 18(1):103-110.
• [6]颜红兵，陈韵岱，郭静萱.腔内影像学和功能学面临的挑战[J].中国介入心脏病学杂志，2017,25(8):421.
• [7]颜红兵，霍勇.病理生物学导向是抗血小板治疗的未来方向[J].中国介入心脏病学杂志，2018, 26(10):541-542.
• [8] Kim BK, Hong SJ, Cho YH, et al. Effect of ticagrelor monotherapy vs ticagrelor with aspirin on major bleeding and cardiovascular events in patients with acute coronary syndrome:The TICO randomized clinical trial[J]. JAMA,2020, 323(23):2407-2416.
• [9] Kedhi E, Fabris E, Van Der Ent M, et al. Six months versus12 months dual antiplatelet therapy after drug-eluting stent implantation in ST-elevation myocardial infarction(DAPTSTEMI):randomised, multicentre, non-inferiority trial[J]. BMJ, 2018, 363:k3793.
• [10] Tomaniak M, Chichareon P, Onuma Y, et al. Benefi t and risks of aspirin in addition to ticagrelor in acute coronary syndromes:a post hoc analysis of the randomized GLOBAL LEADERS trial[J].JAMA Cardiol, 2019, 4(11):1092-1101.
• [11] Ridker PM. Clinician’s guide to reducing inflammation to reduce atherothrombotic risk:JACC review topic of the week[J]. J Am Coll Cardiol, 2018, 72(25):3320-3331.
• [12] Yamamoto E,Yonetsu T,Kakuta T,et al. Clinical and laboratory predictors for plaque erosion in patients with acute coronary syndromes[J]. J Am Heart Assoc,2019,8(21):e012322.
• [13] Khalifa AKM, Kubo T, Ino Y, et al. Optical coherence tomography comparison of percutaneous coronary intervention among plaque rupture, erosion, and calcifi ed nodule in acute myocardial infarction[J]. Circ J, 2020, 84(6):911-916.
• [14] Higuma T, Soeda T, Abe N, et al. A combined optical coherence tomography and intravascular ultrasound study on plaque rupture, plaque erosion, and calcified nodule in patients with ST-segment elevation myocardial infarction:incidence, morphologic characteristics, and outcomes after percutaneous coronary intervention[J]. JACC Cardiovasc Interv, 2015, 8(9):1166-1176.
• [15] Cao M, Zhao L, Ren X, et al. Pancoronary plaque characteristics in STEMI caused by culprit plaque erosion versus rupture:3-vessel OCT study[J]. JACC Cardiovasc Imaging, 2021, 14(6):1235-1245.
• [16] He L, Qin Y, Xu Y, et al. Predictors of non-stenting strategy for acute coronary syndrome caused by plaque erosion:fouryear outcomes of the EROSION study[J]. EuroIntervention,2021, 17(6):497-505.
• [17] Tan Y, Sheng Z, Zhou P, et al. Plasma trimethylamine N-Oxide as a novel biomarker for plaque rupture in patients with ST-segment elevation myocardial infarction[J]. Cir Cardiovasc Interv, 2019, 12(1):e007281.
• [18] Kook H, Jang DH, Kim JH, et al. Identification of plaque ruptures using a novel discriminative model comprising biomarkers in patients with acute coronary syndrome[J]. Sci Rep, 2020, 10(1):20228.
• [19] Li J, Tan Y, Sheng Z, et al. RNA-seq identifi es circulating miRNAs as potential biomarkers for plaque rupture in patients with ST-segment elevation myocardial infarction[J].Genomics, 2021, 113(1 Pt 1):1-10.
• [20] Wang J, Li X, Pu J, et al. Mean platelet volume and coronary plaque vulnerability:an optical coherence tomography study in patients with non-ST-elevation acute coronary syndrome[J].BMC Cardiovasc Disord, 2019, 19(1):128.
• [21] Song L, Chen RZ, Zhao XX, et al. Mean platelet volume/platelet count ratio and culprit plaque morphologies:an optical coherence tomography study in patients with st-segment elevation myocardial infarction[J]. J Cardiovasc Transl Res,2021, 14(6):1093-1103.
• [22] Pan W, Sun M, Wu J, et al. Relationship between elevated plasma ceramides and plaque rupture in patients with STsegment elevation myocardial infarction[J]. Atherosclerosis,2020, 302:8-14.
• [23] Tan Y, Yang S, Chen R, et al. High plasma myeloperoxidase is associated with plaque erosion in patients with ST-segment elevation myocardial infarction[J]. J Cardiovasc Transl Res,2020, 13(6):908-915.
• [24] Li J, Tan Y, Sheng Z, et al. The association between plasma hyaluronan level and plaque types in ST-segment elevation myocardial infarction patients[J]. Front Cardiovasc Med,2021, 8:628529.
• [25] Dong H, Hu S, Sun R, et al. High levels of circulating MicroRNA-3667-3p Are associated with coronary plaque erosion in patients with ST-segment elevation myocardial infarction[J].Int Heart J, 2019, 60(5):1061-1069.
• [26] Li J, Sheng Z, Tan Y, et al. Association of plasma trimethylamine N-Oxide level with healed culprit plaques examined by optical coherence tomography in patients with STSegment elevation myocardial infarction[J]. Nutr Metab Cardiovasc Dis, 2021, 31(1):145-152.
• [27] Tan Y, Zhou J, Liu C, et al. Association between plasma trimethylamine n-oxide and neoatherosclerosis in patients with very late stent thrombosis[J]. Can J Cardiol, 2020, 36(8):1252-1260.
• [28] Sheng Z, Tan Y, Liu C, et al. Relation of circulating trimethylamine n-oxide with coronary atherosclerotic burden in patients with ST-segment elevation myocardial infarction[J].Am J Cardiol, 2019, 123(6):894-898.
• [29] Chang YC,Chu YH,Wang CC,et al. Rapid detection of gut microbial metabolite trimethylamine n-oxide for chronic kidney disease prevention[J]. Biosensors(Basel),2021,11(9):339.
• [30] Sugiyama T, Yamamoto E, Fracassi F, et al. Calcified plaques in patients with acute coronary syndromes[J]. JACC Cardiovasc Interv, 2019, 12(6):531-540.
• [31] Li J, Tan Y, Zhou P, et al. Association of trimethylamine N-Oxide levels and calcification in culprit lesion segments in patients with ST-Segment elevation myocardial infarction evaluated by optical coherence tomography[J].Front Cardiovasc Med, 2021, 8:628471.
• [32] Fujiyoshi K, Minami Y, Ishida K, et al. Incidence,factors, and clinical significance of cholesterol crystals in coronary plaque:an optical coherence tomography study[J].Atherosclerosis, 2019, 283:79-84.
• [33] Cheng JM, Garcia-Garcia HM, De Boer SP, et al. In vivo detection of high-risk coronary plaques by radiofrequency intravascular ultrasound and cardiovascular outcome:results of the ATHEROREMO-IVUS study[J]. Eur Heart J, 2014, 35(10):639-647.
• [34] Fracassi F, Niccoli G, Vetrugno V, et al. Optical coherence tomography and C-reactive protein in risk stratifi cation of acute coronary syndromes[J]. Int J Cardiol, 2019, 286:7-12.
• [35] Prati F, Romagnoli E, Gatto L, et al. Relationship between coronary plaque morphology of the left anterior descending artery and 12 months clinical outcome:the CLIMA study[J].Eur Heart J, 2020, 41(3):383-391.
• [36] Yonetsu T, Hoshino M, Lee T, et al. Plaque morphology assessed by optical coherence tomography in the culprit lesions of the fi rst episode of acute myocardial infarction in patients with low low-density lipoprotein cholesterol level[J]. J Cardiol,2020, 75(5):485-493.
• [37] Corban MT, Hung OY, Mekonnen G, et al. Elevated levels of serum fibrin and fibrinogen degradation products are independent predictors of larger coronary plaques and greater plaque necrotic core[J]. Circ J, 2016, 80(4):931-937.
• [38] Kothari H, Nguyen AT, Yang X, et al. Association of d-dimer with plaque characteristics and plasma biomarkers of oxidationspecifi c epitopes in stable subjects with coronary artery disease[J].J Cardiovasc Transl Res, 2018, 11(3):221-229.
• [39] Chen R, Liu C, Zhou P, et al. Prognostic value of D-dimer in patients with acute coronary syndrome treated by percutaneous coronary intervention:a retrospective cohort study[J].Thromb J, 2021, 19(1):30.
• [40] Ahmadi A, Argulian E, Leipsic J, et al. From subclinical atherosclerosis to plaque progression and acute coronary events:JACC state-of-the-art review[J]. J Am Coll Cardiol, 2019,74(12):1608-1617.
• [41] Zhou J, Tan Y, Liu C, et al. Ticagrelor versus clopidogrel in patients with late or very late stent thrombosis[J]. Cardiovasc Drugs Ther, 2020, 34(5):677-684.
• [42] Spronk HM, De Jong AM, Crijns HJ, et al. Pleiotropic effects of factor Xa and thrombin:what to expect from novel anticoagulants[J]. Cardiovasc Res, 2014, 101(3):344-351.
• [43] Montone RA, Vetrugno V, Camilli M, et al. Macrophage infiltrates in coronary plaque erosion and cardiovascular outcome in patients with acute coronary syndrome[J].Atherosclerosis, 2020, 311:158-166.
• [44] Sheng Z, Zhou P, Liu C, et al. Relationships of coronary culprit-plaque characteristics with duration of diabetes mellitus in acute myocardial infarction:an intravascular optical coherence tomography study[J]. Cardiovasc Diabetol,2019, 18(1):136.
• [45]盛兆雪，赵汉军，颜红兵，等.血浆氧化三甲胺水平与罪犯斑块易损特征的相关性[J].中国介入心脏病学杂志，2019,27(5):271-275.
• [46] Carrero JJ, Andersson Franko M, Obergfell A, et al. Hs-CRP level and the risk of death or recurrent cardiovascular events in patients with myocardial infarction:a healthcare-based study[J]. J Am Heart Assoc, 2019, 8(11):e012638.
• [47] Chen R, Liu C, Zhou P, et al. Both low and high postprocedural hscrp associate with increased risk of death in acute coronary syndrome patients treated by percutaneous coronary intervention[J]. Mediators Infl amm, 2020, 2020:9343475.
• [48] Wang Y, Zhao X, Zhou P, et al. Impact of postprocedural high-sensitivity C-reactive protein on Lipoprotein(a)-associated cardiovascular risk with ST-Segment elevation myocardial infarction with percutaneous coronary intervention[J]. Am J Cardiol, 2021, 150:8-14.
• [49] Koskinas KC, Zaugg S, Yamaji K, et al. Changes of coronary plaque composition correlate with C-reactive protein levels in patients with ST-elevation myocardial infarction following high-intensity statin therapy[J]. Atherosclerosis,2016, 247:154-160.
• [50] Joner M, Koppara T, Byrne RA, et al. Neoatherosclerosis in patients with coronary stent thrombosis：fi ndings from optical coherence tomography imaging(a report of the PRESTIGE consortium)[J]. JACC Cardiovasc Interv, 2018, 11(14):1340-1350.
• [51] Virmani R, Kolodgie FD, Burke AP, et al. Lessons from sudden coronary death:a comprehensive morphological classification scheme for atherosclerotic lesions[J].Arterioscler Thromb Vasc Biol, 2000, 20(5):1262-1275.
• [52] Vergallo R, Crea F. Atherosclerotic plaque healing[J]. N Engl J Med, 2020, 383(9):846-857.
• [53] Vergallo R, Porto I, D’amario D, et al. Coronary atherosclerotic phenotype and plaque healing in patients with recurrent acute coronary syndromes compared with patients with long-term clinical stability:an in vivo optical coherence tomography study[J]. JAMA Cardiol,2019, 4(4):321-329.
• [54] Araki M, Yonetsu T, Kurihara O, et al. Predictors of rapid plaque progression:An optical coherence tomography study[J].JACC Cardiovasc Imaging, 2021,14(8):1628-1638.
• [55]周鹏，颜红兵，刘臣，等.光学相干断层成像指导与冠状动脉造影指导直接经皮冠状动脉介入治疗6个月随访结果的比较[J].中华心血管病杂志，2020, 48(3):217-222.