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Additional evidence for an important role of
inammation in atherosclerosis comes from
statin therapeutic studies. Statins efciently
reduce cardiovascular risk through lowering lowdensity lipoprotein (LDL). Such trials show that
statins reduce inammation (as determined by
CRP) and that such reductions in inammation
associate with improvements in CVD risk [10].
Further, statin-induced changes in LDL and
inammation vary independently, suggesting that
LDL and inammation may represent distinct
therapeutic targets [11]. Large-scale clinical
trials provided further evidence for the importance of targeting inammation to prevent atherosclerotic events. The JUPITER (Justication
for the Use of Statins in Prevention: An
Intervention Trial Evaluating Rosuvastatin) trial
enrolled more than 17,000 subjects without
known CVD who had elevated CRP levels
(hsCRP >2mg/L) and what was at the time considered “lower” LDL concentrations (LDL
<130 mg/dL). In JUPITER, statin therapy
resulted in a 47% relative risk reduction in rst
myocardial infarction, stroke, or cardiovascular
death among individuals with “lower” LDL and
elevated CRP [10]. PROVE-IT (Pravastatin or
Atorvastatin Evaluation and Infection Therapy)
and IMPROVE-IT (Improved Reduction of
Outcomes: Vytorin Efcacy International) trials
provided additional data demonstrating the relevance of lowering hsCRP in the context of lipid
lowering [12, 13]. Together, those studies show
that individuals who achieved lower values for
both LDL and hsCRP experienced lower event
rates compared to those with a reduction in one
biomarker alone. These observations led to the
concept of “residual inammatory risk” to
describe the CVD risk that remains among individuals with low LDL values, yet persistently
elevated inammatory markers [14]. Based on
the aforementioned studies, current guidelines
support the use of hsCRP to rene risk assessment while deliberating on whether to initiate
statins for primary prevention of CVD [15].
More recently, the CANTOS (Canakinumab
Anti-inammatory Thrombosis Outcomes Study),
Colcot (Colchicine Cardiovascular Outcomes
Trial), and LoDoCo2 (Low Dose Colchicine for
secondary prevention of cardiovascular disease)
trials provided robust novel clinical evidence supporting the inammatory hypothesis of atherosclerosis. CANTOS tested whether a selective
anti-inammatory agent (i.e., canakinumab, an
IL-1β monoclonal antibody that has not been
FDA-approved) would improve CVD outcomes
in the absence of cholesterol lowering [16]. In this
study, Ridker et al. reported that canakinumab
resulted in a 15–20% reduction in the rate of
recurrent CVD events despite no change in lipid
concentrations [16]. With these results and the
knowledge that the target of canakinumab, IL-1β,
induces IL-6 production, a key cytokine of innate
immunity, IL-6’s role in atherosclerosis was
placed directly in the spotlight. This interest was
augmented by the fact that CANTOS participants
who received canakinumab and achieved ontreatment IL-6 levels below the study median
value demonstrated a 36% relative risk reduction
in CVD events [17]. Considering these ndings, it
was assumed that inhibition of inammation by
targeting the innate immunity pathway of IL-1β to
IL-6 to hsCRP might be the underlying cause of
canakinumab’s signicant CVD reduction independent of lipid lowering and identify IL-6 as a
possible primary focus of atherothrombosis prevention. In addition, Colcot demonstrated that
daily low-dose colchicine, an effective antiinammatory medication, signicantly lowered
the risk of ischemic cardiovascular events in individuals post recent myocardial infarction [18].
Further, LoDoCo2 also endorsed the benets of
colchicine 0.5mg daily in reducing recurrent coronary events in patients with chronic coronary
disease [19]. Collectively, the above-mentioned
trials provide supportive evidence of a causal role
for inammation in atherosclerotic CVD.
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Noninvasive Molecular Imaging
ofAtherosclerosis Inammation
18
with
F-FDG
Indeed, 18F-FDG-PET/CT imaging has been
used extensively to assess burden of the inammatory atherosclerosis [21]. Several studies
have shown that 18F-FDG accumulates within
18
F-Fluorodeoxyglucose (18F-FDG) positron
emission tomography/computed tomography
(PET/CT) imaging is a widely employed imaging
modality to assess inammation in humans.
18
F-FDG-PET/CT is used to identify and characterize metabolically active tissues such as tumors
and inamed or infected tissues. 18F-FDG is an
FDA-approved radioactive analogue of glucose,
which accumulates within tissues in proportion to
their tissue glycolytic rates [6]. Since inammatory cells, especially pro-inammatory macrophages (e.g., subtype M1), have relatively high
glycolytic rates, inamed tissues tend to accumulate substantially more 18F-FDG than surrounding
the arterial wall in proportion to the density of
atherosclerotic macrophages (Table18.1) [22].
Furthermore, arterial 18F-FDG uptake has been
shown to increase in proportion to risk scores
[23–26] and among individuals with CVD
events [21, 27]. Additionally, arterial locations
manifesting higher inammation are more
likely to subsequently manifest progression of
the underlying atheroma [28, 29]. Additional
human studies demonstrated that arterial 18FFDG uptake independently predicts subsequent
incident atherothrombotic events beyond clinical risk score or the extent of coronary calcication (Figs.18.2 and 18.3) [22, 30].
tissues without inammation [20].
Table 18.1 The list of clinical studies assessing the correlation between 18F-FDG uptake by PET/CT and arterial
inammation on histological analysis of the specimens from carotid endarterectomy
(N) number of patients who underwent carotid endarterectomy, CD45 cluster of differentiation 45, CD68 cluster of differentiation 68, NA not available, SUV, standardized uptake value, TBR target-to-background ratio. (Reprinted with
permission [22])
c
nt)
35)
.2)
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245
Fig. 18.2 Arterial inammation predicts CVD events.
Aortic 18F-FDG uptake is higher in an individual who
experienced a subsequent CVD event (right) compared
a
1
0.8
0.6
0.4
0.2
Event-free survival
0
0
Paulmier et al. 2008
p=0.036
FDG −
FDG +
N=101
123
Month Time (Years)
456
b
10
0.8
0.6
0.4
0.2
Event-free survival
Mean TBR
<1.7 (n = 306, 91.6%)
≥1.7 (n = 28, 8.4%)
p<0.001
0
01020
Time (mo)
Fig. 18.3 Signicant relationship between heightened
arterial wall 18F-FDG uptake and decreased cardiovascular event-free survival has been shown in several studies
**
N=344
30 40
Number at Risk: Adjusted H
with another patient with lower uptake (left). CVD cardiovascular disease, FDG uorodeoxyglucose, TBR
to- background ratio. (Adapted with permission [31])
1.0
0.8
0.6
0.4
Probability
0.2
0
d
1.0
0.9
0.8
0.7
Proportion Free of CVD
0
0
TBR Tertile 1: 167
224
TBR Tertile 2:
122
TBR Tertile 3:
Iwatsuka et al. 2018
Tertile 1 (the lowest)
N=309
Tertile 2
Tertile 3
p=0.005
02468
Figueroa et al. 2013Rominger et al. 2009
p=0.0003
N=503
123
456
Follow-up (Years)
160
149
120
75
36
216
199
170
108
101
112
92
74
10
58
14
40
14
TBR Tertil
≤ 1.84
1.85-2.19
≥ 2.2
1.0 (Refere
1.36 (0.55, 3.
4.71 (1.98, 11
with distinct populations. TBR target-to-background ratio.
(Reprinted with permission [22, 32])
tissue-
e:
R;
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Impact ofTherapies
onAtherosclerosis Inammation
Measured with18F-FDG
18
F-FDG-PET/CT imaging of atherosclerosis has
been repeatedly applied to test therapies targeting atherosclerotic inammation in research
studies. Five drug classes have been evaluated in
both 18F-FDG-PET imaging and clinical endpoint trials [33, 34]. For each of those ve drugs,
there was concordance between directional
changes seen on arterial imaging and clinical
benet observed in large clinical trials. The
imaging and clinical endpoint trials’ ndings
have been concordantly positive for two drug
classes (i.e., statins and thiazolidinediones)
where they reduced both plaque inammation
and clinical cardiovascular events [35, 36]. On
the other hand, three drug classes (i.e., LPPLA2,
CETP, and P38 MAP Kinase inhibitors) resulted
in no reduction in pre-specied 18F-FDG-PET
imaging endpoints or in clinical endpoints [37–
41]. Accordingly, relatively small, and brief
18
F-FDG-PET/CT imaging trials (e.g., 100–200
individuals studied for 3–6 months) have the
potential to provide insights into the eventual
clinical efcacy of drugs targeting atherosclerotic inammation.
Molecular Imaging ofCoronary
Inammation
Most 18F-FDG-PET/CT arterial imaging studies
have focused on larger arteries such as the aorta
and the carotids. However, 18F-FDG-PET/CT
imaging of the coronary arteries has also been
reported. In a retrospective study, Wykrzykowska
etal. rst described coronary 18F-FDG uptake in
subjects placed on a low-carbohydrate, high-fat
diet designed to suppress physiologic myocardial
18
F-FDG uptake [42]. Subsequently, Rogers etal.
[43] and Cheng etal. [34] demonstrated increased
18
F-FDG uptake within coronary culprit lesions
in individuals with acute coronary syndrome
(ACS) versus individuals with stable angina.
Further work has shown that higher coronary 18FFDG uptake associates with high-risk plaque features, such as positive remodeling and increased
lipid content [44]. More recently, Galiuto etal.
demonstrated high correlations between coronary 18F-FDG uptake and high-risk morphological features on coronary optical coherence
tomography (OCT) [45].
However, unlike imaging of larger vessels,
coronary 18F-FDG-PET imaging is much more
challenging. Despite great efforts to minimize
background myocardial uptake of tracer, excess
myocardial tracer uptake often impedes evaluation of coronary 18F-FDG uptake and limits the
practical utility of this imaging approach. To
overcome this, new inroads are being made using
alternative tracers, such as 68Ga-DOTATATE
(Fig.18.4), that are more specic for inammatory cells and are less impacted by adjacent myocardial background uptake [46]. In addition, PET
imaging of coronary plaques faces other technical challenges (i.e., the limited spatial resolution
of PET and motion of coronary arteries) that further limit the clinical utility of the approach. As
such, it is likely that reliable molecular imaging
of coronary inammation imaging will require
combines advances in tracers as well as imaging
technologies.
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a bc
d
ef g
hi j
Fig. 18.4 Comparison between gallium-68-labeled
DOTATATE (68Ga-DOTATATE) and 18F-FDG-PET imaging of coronary inammation. Images belong to a patient
with ACS and an electrocardiogram showing deep anterolateral T-wave inversions (a). Coronary angiography
shows the culprit left anterior descending artery stenosis
noted by dashed oval (b). A stent was placed (c). Coronary
CT angiography revealed a residual coronary plaque
(*inset) at the distal end of the stent with high-risk features such as low attenuation and spotty calcication (d,
Microcalcication Activity
andOther Targets forMolecular
Imaging ofAtherosclerotic Plaque
Several additional plaque features besides
inammation represent attractive targets for
molecular imaging (Fig. 18.1). Such features
include increased oxidative stress, hypoxia,
hypoxia- induced angiogenesis, dysregulation of
matrix metalloproteinase activity, and microcal-
68
e).
Ga-DOTATATE PET (f, h, i) clearly spotted intense
inammation at the distal residual plaque (f, arrow) as
well as the recently infarcted myocardium (i, *). However,
18
F-FDG-PET (g, j) showed intense background myocardial uptake, which entirely obscured uptake within the
coronary arteries. ACS acute coronary syndrome, CT
computed tomography,
PET positron emission tomography. (Reprinted with permission [46])
18
F-FDG uorodeoxyglucose,
cication activity. In an animal study, increased
18
F-uoromisonidazole (18F-FMISO) uptake has
been associated with plaque hypoxia [47]. In separate studies, 68Ga-NOTA-RGD and 18F-GalactoRGD targeted (integrin avb3) expression on
activated endothelial cells correlated with neoangiogenesis in advanced atheromatous lesions [48,
49] (Fig.18.1, Table18.2).
One tracer of note, 18F-sodium uoride (18FNaF) incorporates into hydroxyapatite during
osteogenesis and accumulates within areas of
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Table 18.2
A list of current PET agents targeting atherosclerotic inammation and their potential mechanisms of
uptake
Agent Potential mechanism of uptake
18
F-Macroor Has afnity for cardiovascular resident macrophages
18
F-Cerezyme Has afnity for mannose receptors on macrophages
18
F-FMCH Targets macrophage cell membrane
18
F-Galacto-
RGD
18
F-FDM An isomer of 18F-FDG that accumulates within inamed tissues with possibly greater afnity
Binds to integrin avb3 expressed by macrophages and activated endothelial cells (associated
with angiogenesis)
for M2-polarized macrophages
18
F-FOL
11
C-PK11195 Has afnity for translocator protein, which is upregulated on inammatory cells
68
Ga-CXCR4 Binds to inammatory cells expressing the CXCR4 receptor
68
Ga-DOTA-
octreotate
18
F-FDG A glucose analogue that accumulates within cells in proportion to glycolysis
18
F–NaF Accumulates within areas of active micro-calcication that are indirectly related to
Binds to the folate receptor β (FR-β) that is selectively expressed by macrophages
Binds to inammatory cells expressing somatostatin receptors that are highly expressed on
macrophages
inammation
18
F-choline Identies heightened cell wall synthesis within atheroma
64
Cu-ATSM Accumulates in hypoxic regions
18
F-MISO Accumulates in hypoxic regions
68
Ga-NOTA-
RGD
64
Cu-DOTA-
Binds to integrin avb3 expressed by macrophages and activated endothelial cells that are
associated with angiogenesis
Has afnity to natriuretic peptide receptor and is used in imaging neoangiogenesis
CANF
18
F-A85380 Binds arterial nicotinic acetylcholine receptors that are possibly related to vascular damage
18
F-FLT A labeled thymidine analogue that can identify myelopoiesis in the bone marrow and myelocyte
turnover in the blood vessel wall
11
C-PK11195 11C-(2-chlorophenyl)-N-methyl-N-(1- methylpropyl)-3-isoquinolinecarboxamide, A85380 3-([2S]-azetidi-
nyl-methoxy) pyridine dihydrochloride, ATSM diacetyl-bis(N-methyl-thiosemicarbazone, CXCR4 C-X-C chemokine
receptor type 4, DOTA-CANF 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid atrial natriuretic factor, FDG uo-
rodeoxyglucose, FDM uoro-deoxymannose, FLT uoro-thymidine, MISO
NOTA-RGD
1,4,7-triazacyclononane-N,N0,N00-triacetic acid arginine- glycine-aspartate. (Adapted with permission [50])
uoro- misonidazole, NaF sodium uoride,
active calcication. Clinically, 18F-NaF has long
been used to evaluate bone pathologies. More
recently, it has been leveraged to identify areas of
active microcalcication (i.e., calcications
<50μm in size), a feature of biologically active
high-risk plaques that is beneath the threshold of
detection by CT imaging (i.e., coronary artery
calcium [CAC]) [51, 52]. Notably, 18F-NaF activity can be more readily measured in the coronaries (as compared to
18
F-FDG), owing to the
relatively low background activity and lack of
myocardial spill-over [51].
Importantly, culprit coronary and carotid
plaques have shown higher 18F-NaF uptake
b
a
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than asymptomatic atheroma [53] (Fig. 18.5).
Moreover, in patients with established coronary
artery disease, 18F-NaF uptake throughout the
coronary arteries quantied as coronary microcalcication activity (CMA) independently predicts
coronary events beyond traditional risk stratication methods [54] (Fig.18.6). 18F-NaF uptake also
identies coronary segments which subsequently
showed rapid progression of coronary calcica-
c
d
tion [55]. Further, higher 18F-NaF uptake predicts
peripheral arterial restenosis after percutaneous
transluminal angioplasty [56]. Additionally, 18FNaF has demonstrated promise in the evaluation
of abdominal aortic aneurysms in which it has
been shown to independently predict aneurysm
growth and future clinical events [57].
e
5
4
3
2
1
Tissue-to-background ratio
0
Culprit plaque
Fig. 18.5 Increased 18F-NaF uptake in culprit coronary
lesions. Individuals with recent myocardial infarction
(MI) underwent 18F-NaF-PET/CT.Coronary angiograms
show culprit left anterior descending artery lesions (red
arrows) in two individuals (a and c) with recent MI.Intense
radiotracer uptake has been shown in the same locations
of the same patients (b and d) who underwent 18F-NaFPET/CT.Higher 18F-NaF activity was noted in the culprit
lesions compared with nonculprit lesions in the same individuals (e). (Reprinted with permission [58])
Maximum
non-culprit plaque
250
Patients with advanced established
Continue medical therapy
Close Observation
Intensify Therapy
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A. Radfar et al.
coronary artery disease
Coronary disease activity on 18F-NaF PET:
the only predictor of fata or non-fatal MI
(independent of calcium score, coronary artery lumen stenosis,
CMA 0.00 CMA 0.97 CMA 14.76
No Activity
(CMA=0)
NO MI on follow up
Fig. 18.6 18F-NaF-PET imaging of coronary calcica-
tion to assess disease activity. In patients with known
CAD, the burden of coronary 18F-NaF uptake predicts
future coronary atherosclerotic events. Coronary microcalcication activity (CMA) was assessed by using
18
F-NaF-PET.Based on the amount of tracer uptake, individuals were categorized into no, low, and high disease
activity. Those with higher 18F-NaF uptake (i.e., CMA
risk score & co-morbidities)
Low Activity
(CMA=0.01 to 1.56)
Intermediate risk
High Activity
(CMA > 1.56)
8-fold risk of future MI
>1.56) exhibited an eightfold risk of future MI.Despite
having advanced CAD, individuals with no 18F-NaF
uptake (i.e., CMA= 0) had no MI during the study follow- up. CAD coronary artery disease, CMA coronary
microcalcication activity, CT computed tomography,
18
F-NaF 18F-sodium uoride, MI myocardial infarction,
PET positron emission tomography. (Reprinted with per-
mission [54])
Hybrid PET/Magnetic Resonance
Imaging (MRI) Systems
PET/MRI is an emerging imaging technology
that may provide advantages over PET/CT in certain applications. Potential advantages include
enhanced soft tissue characterization, improved
ability to evaluate cardiac structure, better assessment of ventricular function, and reduced exposure to ionizing radiation by omitting CT
imaging. Further, MRI data are acquired simulta-
neously along PET data, allowing for better registration of the two datasets.
Several groups have demonstrated the feasibility of PET/MRI for the evaluation of atherosclerosis [59]. Robson etal. outlined a specialized
approach to using PET/MRI to assess inammation and microcalcication in the coronary arteries [60]. In an animal study, Calcagno et al.
presented an integrated PET dynamic contrastenhanced MRI (PET-DCE/MRI) protocol to
measure rabbit aortic plaque inammation, neo-
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251
angiogenesis, permeability as well as test the efcacy of an experimental drug [61]. In addition,
Senders etal. employed an integrative PET/MRI
protocol in rabbits for plaque phenotyping by targeting vascular cell adhesion molecule (VCAM)1, lectin-like oxidized low-density lipoprotein
receptor (LOX)-1, and macrophage mannose
receptor (MMR). The study was conducted in
concordance with using other clinically approved
modalities such as 18F-FDG, 18F-NaF, and MRI
[62]. PET/MRI has the potential to facilitate multiparametric analysis of atherosclerosis, including plaque stenosis severity, hemodynamic
markers, plaque composition, and activity along
with the evaluation of myocardial viability.
Accordingly, such information derived from this
unied imaging modality seems to offer a unique
approach to assess anti-atherosclerotic drug efcacy in the early phases of clinical trials.
Multimodality Molecular Imaging
Approaches
Multimodality molecular imaging has been
developed to obtain detailed structural, functional, and molecular data. Combining the capability of various imaging modalities (e.g., PET/
CT, PET/MRI) offers the feasibility to derive
pathobiological insights and potential translation
into the clinical realm.
Importantly, multimodal, multiorgan imaging
uniquely allows for the evaluation of disease processes that span multiple organ systems. Several
animal studies show that bone marrow myelopoietic activity accelerates atherosclerosis [63]. For
instance, Emami etal. leveraged 18F-FDG-PET/
CT to study the role of hematopoietic tissues
(i.e., bone marrow, spleen) in human atherosclerotic disease [64]. The investigators quantied
18
F-FDG uptake in hematopoietic tissues and
observed that the signal is: 1) heightened among
individuals with recent acute coronary syndrome
and 2) associated with circulating inammatory biomarkers as well as arterial inammation. Moreover, in a complementary study of
513 individuals without prior CVD, hematopoietic activity independently predicted the risk of
future CVD events, illuminating the presence
of a hematopoietic-arterial axis in humans. The
link between hematopoietic tissues and atherosclerosis has been further studied using the PET
tracer 3′-deoxy-3′-[18F]-uoro-thymidine (18FFLT), a thymidine analogue which accumulates
in proliferating cells [65]. Using 18F-FLT PET,
myelopoietic stem and progenitor cell proliferation were found to be greater among individuals
with atherosclerosis with increased tracer uptake
in atherosclerotic plaques within macrophages in
the above-mentioned cells and lesions. Further,
multiorgan 18F-FDG-PET/CT imaging has been
employed to demonstrate a link between chronic
stress, a known CVD risk factor, and CVD via the
aforementioned hematopoietic-arterial axis [66,
67]. A recent study showed that stress-associated
neural activity involving the amygdala, a crucial
constituent of the brain’s salience network, independently and robustly associated with the risk
of subsequent CVD events. Moreover, mediation analysis suggested that it did so in part via
the following pathway: ↑amygdalar activity →
↑bone marrow activity → ↑arterial inammation → ↑CVD risk [31]. Hence, molecular imaging can also be leveraged provide unique and
important insights into multi-system biological
mechanisms.
Clinical Applications
Current clinical applications for arterial molecular imaging are limited. 18F-FDG-PET imaging is
used clinically to evaluate arterial inammation
in the context of known or suspected arteritis,
where this application is supported by the clinical
guidelines [68]. Yet, arterial molecular imaging
to evaluate CVD risk is not widely performed.
Before broad clinical implementation is possible,
large prospective trials are needed to dene the
incremental value of the approach to predict
subsequent CVD events. One such trial,
“Prognostic Value of Arterial 18F-FDG PET
Imaging in Patients with History of Myocardial
Infarction: PIAF” (funded by the International
Atomic Energy Agency) is assessing the relationship between arterial 18F-FDG uptake and subse-
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quent CVD events in >1200 individuals. The
relationship between tracer uptake and CVD risk
will similarly need to be evaluated for other tracers before they are used broadly. Until those data
are available, arterial molecular imaging of atherosclerosis will remain largely a research tool.
Conclusion
Atheromatous plaque biology represents an
exciting target for molecular imaging of atherosclerosis, offering functional information to
improve our understanding of the underlying
pathophysiology. Current imaging techniques
targeting pathobiological processes, such as
inammation, improve risk assessment and may
lead to improved clinical decision making. The
continued evolution of molecular imaging to
assess inammation and other important pathobiological processes in atherosclerosis has the
potential to enhance the personalization of therapies and improve outcomes.
References
1. Barquera S, Pedroza-Tobías A, Medina C, HernándezBarrera L, Bibbins-Domingo K, Lozano R, et al.
Global overview of the epidemiology of atherosclerotic cardiovascular disease. Arch Med Res.
2015;46(5):328–38.
2. Libby P, Ridker PM, Maseri A.Inammation and atherosclerosis. Circulation. 2002;105(9):1135–43.
3. Ross R.Atherosclerosis—an inammatory disease. N
Engl J Med. 1999;340(2):115–26.
4. Kuiper J, van Puijvelde GHM, van Wanrooij EJA, van
Es T, Habets K, Hauer AD, etal. Immunomodulation
of the inammatory response in atherosclerosis. Curr
Opin Lipidol. 2007 Oct;18(5):521–6.
5. Tabas I, García-Cardeña G, Owens GK. Recent
insights into the cellular biology of atherosclerosis. J
Cell Biol. 2015;209(1):13–22.
6. Joseph P, Tawakol A. Imaging atherosclerosis
with positron emission tomography. Eur Heart J.
2016;37(39):2974–80.
7. Libby P.Inammation in atherosclerosis. Arterioscler
Thromb Vasc Biol. 2012;32(9):2045–51.
8. Burke AP, Tracy RP, Kolodgie F, Malcom GT, Zieske
A, Kutys R, et al. Elevated C-reactive protein values and atherosclerosis in sudden coronary death:
association with different pathologies. Circulation.
2002;105(17):2019–23.
9. Ridker PM, Buring JE, Rifai N, Cook
NR. Development and validation of improved algorithms for the assessment of global cardiovascular
risk in women: the Reynolds Risk Score. JAMA.
2007;297(6):611–9.
10. Ridker PM, Danielson E, Fonseca FAH, Genest
J, Gotto AM Jr, Kastelein JJP, et al. Rosuvastatin
to prevent vascular events in men and women
with elevated C-reactive protein. N Engl J Med.
2008;359(21):2195–207.
11. Geovanini GR, Libby P. Atherosclerosis and inammation: overview and updates. Clin Sci (Lond).
2018;132(12):1243–52.
12. Ridker PM, Cannon CP, Morrow D, Rifai N, Rose
LM, McCabe CH, et al. C-reactive protein levels
and outcomes after statin therapy. N Engl J Med.
2005;352(1):20–8.
13. Bohula EA, Giugliano RP, Cannon CP, Zhou J,
Murphy SA, White JA, etal. Achievement of dual lowdensity lipoprotein cholesterol and high- sensitivity
C-reactive protein targets more frequent with the
addition of ezetimibe to simvastatin and associated
with better outcomes in IMPROVE-IT. Circulation.
2015;132(13):1224–33.
14. Ridker PM.Clinician’s guide to reducing inammation
to reduce atherothrombotic risk: JACC review topic of
the week. J Am Coll Cardiol. 2018;72(25):3320–31.
15. Grundy SM, Stone NJ, Bailey AL, Beam C, Birtcher
KK, Blumenthal RS, etal. 2018 AHA/ACC/AACVPR/
AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/
PCNA guideline on the management of blood cholesterol: executive summary: a report of the American
College of Cardiology/American Heart Association
Task Force on Clinical Practice Guidelines. J Am Coll
Cardiol. 2019;73(24):3168–209.
16. Ridker PM, Everett BM, Thuren T, MacFadyen JG,
Chang WH, Ballantyne C, et al. Antiinammatory
therapy with Canakinumab for atherosclerotic disease. N Engl J Med. 2017;377(12):1119–31.
17. Ridker PM, Libby P, MacFadyen JG, Thuren T,
Ballantyne C, Fonseca F, et al. Modulation of the
interleukin-6 signalling pathway and incidence rates
of atherosclerotic events and all-cause mortality:
analyses from the Canakinumab Anti-Inammatory
Thrombosis Outcomes Study (CANTOS). Eur Heart
J. 2018;39(38):3499–507.
18. Tardif J-C, Kouz S, Waters DD, Bertrand OF, Diaz R,
Maggioni AP, et al. Efcacy and safety of low-dose
colchicine after myocardial infarction. N Engl J Med.
2019;381(26):2497–505.
19. Fischer BG.Colchicine in patients with chronic coronary disease. N Engl J Med. 2021;384(8):777.
20. Tawakol A, Singh P, Mojena M, Pimentel-Santillana
M, Emami H, MacNabb M, etal. HIF-1α and PFKFB3
mediate a tight relationship between proinammatory
activation and anerobic metabolism in atherosclerotic macrophages. Arterioscler Thromb Vasc Biol.
2015;35(6):1463–71.
21. Rudd JHF, Warburton EA, Fryer TD, Jones HA,
Clark JC, Antoun N, et al. Imaging atherosclerotic
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