Atherosclerosis
Atherosclerosis
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动脉粥样硬化
DOI：
10.1038/s41572-019-0106-z
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发表时间：
2019-08-16
影响因子：
81.5
通讯作者：
Lewis, Eldrin F.
中科院分区：
文献类型：
--
作者：
Libby, Peter;Buring, Julie E.;Lewis, Eldrin F.
动脉粥样硬化，即动脉壁纤维脂肪病变的形成，在世界范围内引起许多发病率和死亡率，包括大多数心肌梗死和许多中风，以及致残性外周动脉疾病。动脉粥样硬化病变的发展可能需要低密度脂蛋白，一种携带胆固醇通过血液的颗粒。动脉粥样硬化及其血栓并发症的其他危险因素包括高血压、吸烟和糖尿病。越来越多的证据也表明免疫系统的作用，因为新出现的风险因素包括炎症和克隆造血。对动脉粥样硬化形成的细胞和分子生物学的研究已经提供了相当多的了解，将所有这些危险因素与动脉粥样硬化的发展和这种疾病的临床表现联系起来的机制。一系列诊断技术，包括侵入性（如选择性冠状动脉造影）和非侵入性（如血液生物标志物、压力测试、CT和核扫描），可以评估心血管疾病风险和靶向治疗。一个不断扩大的医疗设备的治疗，可以修改风险因素，并赋予临床效益是可用的，但是，我们面临着相当大的挑战，在提供公平获得这些治疗，并在最大限度地遵守。然而，研究成果的临床应用推进了预防策略，增强了受影响个体的临床结果，并改善了他们的生活质量。迅速增加知识和继续研究有望在防治这一常见慢性病方面取得进一步进展。
Atherosclerosis, the formation of fibrofatty lesions in the artery wall, causes much morbidity and mortality worldwide, including most myocardial infarctions and many strokes, as well as disabling peripheral artery disease. Development of atherosclerotic lesions probably requires low-density lipoprotein, a particle that carries cholesterol through the blood. Other risk factors for atherosclerosis and its thrombotic complications include hypertension, cigarette smoking and diabetes mellitus. Increasing evidence also points to a role of the immune system, as emerging risk factors include inflammation and clonal haematopoiesis. Studies of the cell and molecular biology of atherogenesis have provided considerable insight into the mechanisms that link all these risk factors to atheroma development and the clinical manifestations of this disease. An array of diagnostic techniques, both invasive (such as selective coronary arteriography) and noninvasive (such as blood biomarkers, stress testing, CT and nuclear scanning), permit assessment of cardiovascular disease risk and targeting of therapies. An expanding armamentarium of therapies that can modify risk factors and confer clinical benefit is available; however, we face considerable challenge in providing equitable access to these treatments and in maximizing adherence. Yet, the clinical application of the fruits of research has advanced preventive strategies, enhanced clinical outcomes in affected individuals, and improved their quality of life. Rapidly accelerating knowledge and continued research promise to provide further progress in combating this common chronic disease.