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Articles by E. Falk
Total Records ( 2 ) for E. Falk
  T Thim , M. K Hagensen , D Wallace Bradley , J. F Granada , G. L Kaluza , L Drouet , W. P Paaske , H. E Botker and E. Falk
  Background—

Intravascular ultrasound–derived virtual histology (VH IVUS) is used increasingly in clinical research to assess composition and vulnerability of coronary atherosclerotic lesions. However, the ability of VH IVUS to quantify individual plaque components, in particular the size of the destabilizing necrotic core, has never been validated. We tested for correlation between VH IVUS necrotic core size and necrotic core size by histology in porcine coronary arteries with human-like coronary disease.

Methods and Results—

In adult atherosclerosis-prone minipigs, 18 advanced coronary lesions were assessed by VH IVUS in vivo followed by postmortem microscopic examination (histology). We found no correlation between the size of the necrotic core determined by VH IVUS and histology. VH IVUS displayed necrotic cores in lesions lacking cores by histology.

Conclusions—

We found no correlation between necrotic core size determined by VH IVUS and real histology, questioning the ability of VH IVUS to detect rupture-prone plaques, so-called thin-cap fibroatheromas.

  B. G Nordestgaard , A. S Adourian , J. J Freiberg , Y Guo , P Muntendam and E. Falk
 

Background: Limited information is available regarding risk factors for the near-term (4 years) onset of myocardial infarction (MI). We evaluated established cardiovascular risk factors and putative circulating biomarkers as predictors for MI within 4 years of measurement.

Methods: We conducted a matched, nested case-control study (252 cases and 499 controls) drawing on 45 735 men and women participating in the Copenhagen City Heart Study and the Copenhagen General Population Study. Established risk factors and 17 putative biomarkers, including inflammation-sensitive plasma proteins (C-reactive protein, fibrinogen, l-antitrypsin, complement 3), apolipoproteins (A1, B, E, B/A1 ratio), markers of iron overload (iron, transferrin, transferrin saturation), creatinine, alkaline phosphatase, -glutamyl transpeptidase, and leukocytes (lymphocyte count, neutrophil count, neutrophil/lymphocyte ratio) were assessed.

Results: Among women and men, only 13% and 50%, respectively, of those with near-term MI were classified as high risk by Framingham risk score at baseline. After adjustment for established risk factors, odds ratios for near-term MI, which compared highest to lowest quintiles, were 2.87(95% CI 1.51–5.48; P = 0.001) for l-antitrypsin, 2.84(1.42–5.67; P = 0.003) for C-reactive protein, 1.97(1.09–3.57; P = 0.03) for creatinine, 1.99(1.09–3.65; P = 0.03) for fibrinogen, and 0.37(0.19–0.73; P = 0.004) for iron. The corresponding odds ratio for all biomarkers combined was 7.24 (3.28–16.0; P < 0.001).

Conclusions: We identified 5 biomarkers associated with increased near-term risk of MI independently of established risk factors. All putative biomarkers combined explained a 7-fold increase in the odds of near-term MI.

 
 
 
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