Monitoring anti-inflammatory therapies in patients with atherosclerosis: FDG PET emerges as the method of choice

Excerpt

Complications of cardiovascular disease continue to be the leading cause of death in the western world, despite significant advances over the past 20 years in its treatment [1]. While the incidence of cardiovascular disease declined somewhat between 1994 and 2004 [2], there remains an excessively high rate of sudden death due to cardiovascular events in apparently healthy individuals without prior symptoms [3]. Cardiovascular events are most frequently caused by sudden rupture of a vulnerable atherosclerotic plaque, resulting in either thrombotic occlusion at the site of rupture, or distal embolization [4]. It is now understood that a complex cascade of mechanisms results in transformation of a stable plaque into a vulnerable, unstable lesion prone to rupture. In brief, early atherosclerotic lesions are colonized by blood-born inflammatory and immune cells which release cytokines and other effector molecules, which in turn accelerate and exacerbate progression of the plaque pathology [5]. In recent years, atherosclerotic disease has come to be recognized as a generalized inflammatory process of the arterial wall [6], an insight which has given rise to the concept of the “vulnerable cardiovascular patient” [3]. …