Bioresorbable Vascular Scaffolds to Treat Atherosclerotic Vulnerable Plaques
발표자
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초록
내용
Ischemic heart disease remains the leading cause of death worldwide, with many coronary events resulting from the rupture or erosion of atherosclerotic vulnerable plaques. These plaques are often not flow-limiting but still pose a significant risk of acute coronary syndrome (ACS) and sudden cardiac death. Current clinical guidelines recommend percutaneous coronary intervention for flow-limiting lesions, yet studies indicate that cardiovascular events frequently originate from non-flow-limiting vulnerable plaques despite optimal medical therapy.
Thus, there is a critical need for preventive measures targeting these plaques to reduce adverse cardiovascular outcomes. Recent studies suggest that local preventive revascularization of vulnerable plaques could significantly mitigate cardiovascular risks. Notably, bioresorbable vascular scaffolds (BRS) have shown promise in stabilizing plaques, reducing inflammation, and enlarging coronary lumen. These findings underscore the potential of targeted local therapies in improving patient outcomes beyond what is achievable with current medical treatments alone.
We propose a novel drug delivery system combining nanoparticles with BRS to treat high-risk vulnerable plaques. The nanoparticle SWNT-SHP1i, developed by Stanford researchers, selectively inhibits CD47-SIRPα signaling in monocytes and macrophages, promoting efferocytosis and reducing plaque burden. By delivering SWNT-SHP1i directly to the plaque via coronary intervention, we aim to stabilize and reduce vulnerable plaques, thus preventing ACS. This innovative approach could address the limitations of periodic nanoparticle injections, offering a cost-effective and targeted therapy to improve clinical outcomes for patients with coronary artery disease.