Evidence map›Paper›PMID 28923905›Full record

ReviewCirculation2017

Acute Coronary Syndromes: The Way Forward From Mechanisms to Precision Treatment.

Filippo Crea, Peter Libby

2 registry-linked trialsOpen access · bronzeAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Circulation, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 242 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
242citing papers in PubMed, 3 pooled it
36.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04012294 phase3unknown statusnot on this mapstarted 2019, after this paper: background citation

Effects of Allopurinol on Inflammatory Markers and Morphostructural Changes Evidenced by Musculoskeletal Ultrasound in Individuals With Asymptomatic Hyperuricemia. A Proof of Concept

TypeinterventionalSponsorInstituto Nacional de Cardiologia Ignacio ChavezRan2019 to 2021Enrolled200ConditionsMusculoskeletal Degeneration, Inflammation, HyperuricemiaArmsAllopurinol Pill
NCT06665919 nacompletednot on this mapstarted 2023, after this paper: background citation

Randomized Controlled Trial for Evaluating CYP2C19 Allele Genotype-guided Clopidogrel Treatment Outcomes in Real-world Practice After the ePCI

TypeinterventionalSponsorVistamedi Ltd.Ran2023 to 2025Enrolled283ConditionsCoronary Artery Disease, Clopidogrel Resistance, Coronary Thrombosis, Adverse Cardiac EventsArmsCYP2C19 Genotype-Guided Clopidogrel Treatment, CYP2C19 Genotype Guided Antiplatelet Treatment Alternative to Clopidogrel, The Conventional Clopidogrel Treatment
3 · Its place in the literature

Who cites it

242 citing papers in PubMed, 3 syntheses or guidelines pooled it, 471 citations in OpenAlex.

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  17. Four new markers of early thrombotic molecules and thromboelastography in prognostic evaluation of AMI patients undergoing PCI.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2026
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182 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors at 1 institution in 1 country.

Filippo CreaFrom Department of Cardiovascular and Thoracic Sciences, Catholic University, Rome, Italy (F.C.); and Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (P.L.).
Peter LibbyFrom Department of Cardiovascular and Thoracic Sciences, Catholic University, Rome, Italy (F.C.); and Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (P.L.). plibby@bwh.harvard.edu.
Università Cattolica del Sacro Cuore · IT

Funding

Molecular Determinants of Arterial Remodeling in AtherogenesisR01HL080472 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI LIBBY, PETER · 2005 to 2018
$5.0M
NHLBI NIH HHS R01 HL080472
6 · The paper itself

Abstract

Well into the 21st century, we still triage acute myocardial infarction on the basis of the presence or absence of ST-segment elevation, a century-old technology. Meanwhile, we have learned a great deal about the pathophysiology and mechanisms of acute coronary syndromes (ACS) at the clinical, pathological, cellular, and molecular levels. Contemporary imaging studies have shed new light on the mechanisms of ACS. This review discusses these advances and their implications for clinical management of the ACS for the future. Plaque rupture has dominated our thinking about ACS pathophysiology for decades. However, current evidence suggests that a sole focus on plaque rupture vastly oversimplifies this complex collection of diseases and obscures other mechanisms that may mandate different management strategies. We propose segmenting coronary artery thrombosis caused by plaque rupture into cases with or without signs of concomitant inflammation. This distinction may have substantial therapeutic implications as direct anti-inflammatory interventions for atherosclerosis emerge. Coronary artery thrombosis caused by plaque erosion may be on the rise in an era of intense lipid lowering. Identification of patients with of ACS resulting from erosion may permit a less invasive approach to management than the current standard of care. We also now recognize ACS that occur without apparent epicardial coronary artery thrombus or stenosis. Such events may arise from spasm, microvascular disease, or other pathways. Emerging management strategies may likewise apply selectively to this category of ACS. We advocate this more mechanistic approach to the categorization of ACS to provide a framework for future tailoring, triage, and therapy for patients in a more personalized and precise manner.

Indexed as

Acute Coronary SyndromeAdaptive ImmunityAnti-Inflammatory AgentsC-Reactive ProteinHumansPlaque, AtheroscleroticThrombosisTomography, Optical CoherenceAnti-Inflammatory AgentsC-Reactive Proteinerosioninflammationmicrovesselsmyocardial infarctionplaqueplaque, atheroscleroticthrombosis

Identifiers

PMID28923905
PMCPMC5679086
OpenAlexW2754330582

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.