36 Several attempts have been made to propose novel techniques for the detection of macrophage-rich atherosclerotic plaques in hyperlipidemic animals.37,38 Other putative and novel risk factors like increased inflammatory response-related factors (e.g., C-reactive protein [CRP]) also have been shown to be effective in atherosclerosis development.39-41 Variation in trace elements also plays a crucial role in the initiation and establishment of atherosclerosis.42-44 Inhibitors,research,lifescience,medical The effects of these putative and novel risk factors on atherosclerosis velocity also have not been revealed

in previous studies. Risk factors still cannot predict cardiovascular events perfectly insofar as atherogenesis is a multi-step

process and critical transitions between the aforementioned phases of atherosclerosis require a complex of risk factors, which may differ for each step.45 Imaging and Biochemical Biomarkers: a Key for Further Atherosclerosis Velocity Studies It has been demonstrated that an inflamed arterial wall Inhibitors,research,lifescience,medical with upregulated adhesion molecules is a basic factor which leads to leukocyte migration into the arterial wall; and with increasing levels of activated leukocyte products (like interleukin 6), hepatic CRP may be induced.39 Inflammation has been shown to be allied to the presence and severity of atherosclerotic vascular disease.46 Inhibitors,research,lifescience,medical Deposition of LDL-C over the inflamed arterial wall results in fatty streak formation by recruiting vascular Inhibitors,research,lifescience,medical smooth muscle cells and can eventually form fibrous plaques.39 Fibrous plaques are the end product of the infrastructural phase of atherosclerosis. Due to the characteristics of the fibrous plaque (stable or unstable), the subsequent second phase of atherosclerosis is expected.47,48 Several invasive and selleck kinase inhibitor noninvasive techniques Inhibitors,research,lifescience,medical have been proposed to assess the quality of atherosclerotic plaques. Optical coherence tomography (OCT) and IVUS have shown sufficient feasibility to characterize lipid-rich

plaques and fibrous plaques.49,50 As regards the volume of plaques, MRI seems to be a reliable noninvasive technique for tracking the regression and progression of atherosclerotic plaques.30 Recently, a combination of multi-vessel IVUS and near-infrared spectroscopy techniques has no exhibited promising efficacy in the detection of the development of inflamed fibroatheromas with thinner fibrous caps, greater plaques, and necrotic core areas possessing the characteristics of increased plaque instability.51 We think that one of the most important factors which determine atherosclerosis velocity is the mechanical stability of the plaque. Unstable plaques with thinner fibrous caps and an excess of inflammatory cells in the outer region47,52,53 are prone to induce acute thrombosis and subsequent cardiac events. However, all ruptures may not result in ACS.