Vulnerable plaque and vascular remodelling

  • Tsaousi, Aikaterini (Researcher)
  • Newby, Andrew C (Principal Investigator)

Project Details

Description

Partnership: University Hospitals Bristol NHS Foundation Trust & University of Bristol

Cardiovascular disease (CVD) causes 40% of all deaths in the UK and an estimated two million people are living with CVD. From post-mortem studies we know that 75% of myocardial infarctions (MIs) and many strokes result from rupture of a vulnerable atherosclerotic plaque and subsequent thrombus formation. Moreover patients who died after a coronary plaque rupture were more likely to be older, be men and have larger infarcts than those who had other pathologies. Plaque rupture is also responsible for many secondary major adverse cardiac events (MACE) in survivors. It is possible, therefore, that sufferers of plaque rupture will have different risk profiles than those without rupture. However, there is currently no way to distinguish those surviving patients that have had a plaque rupture from those who have not and therefore it is unknown whether we should be treating these patients more or less aggressively. Moreover current treatments for patients with unstable cardiovascular syndromes are limited to risk factor reduction rather than targeting the aetiology of plaque rupture or erosion.

Our part within the wider aims and objectives of this research area is to look for prognostic biomarkers for plaque instability that could be used in patients at risk of MI using the existing AtheroExpress (Utrecht, NL) and Bristol Coronary Biobank tissue banks (Biobank studies). Our hypotheses are:
(1) Vulnerable plaques are associated with markers of hypoxia/ classical macrophage activation in carotid atherectomy and coronary tissues of patients. (2) Markers of hypoxia/macrophage activation in plaques from atherectomy tissues are associated with risk of MACE at 5-8 years following surgery.

*Professor Andrew Newby was among the first to identify a role for MMPs in vascular remodelling and is an international leader in MMP pathobiology. Recently he has shown that MMPs can be used to characterise pathogenic macrophage phenotypes.


Key findings

research is currently ongoing
AcronymNIHR Biomedical Research Unit
StatusActive
Effective start/end date1/04/13 → …