Prof Robin Choudhury, Professor of Cardiovascular Medicine at University of Oxford and Consultant Cardiologist at John Radcliffe Hospital, Oxford, UK, speaks with Cardio Debate & Radcliffe Cardiology about Inflammation and Ischaemic Heart Disease during the “Advances in the Pathogenesis and Management of Cardiovascular Disease” 2015 meeting, organised by the Cardiovascular Sciences Research Centre of St George’s University and held at the Royal College of Surgeons of England in London, UK.
How important is inflammation in the pathogenesis of coronary heart disease?
The role of inflammation both in the initiation and the propagation of atherosclerotic cardiovascular disease, it’s a very complex area, it spans both adaptive and innate immunity and we can see evidence from multiple strands – be it from animal models, from human epidemiology, from the studies of human tissue to some extent, from large-scale genetic studies – that inflammation seems to have a clear and mechanistic role in atherogenesis.
The real question is whether or not treating inflammation will affect patient outcomes.
How will detection of plaque inflammation help patient management?
So if we take as a starting point that inflammation is important in the pathogenesis of this disease, then clearly in terms of diagnosis, in grading severity, stratifying patients to receive specific treatments, the ability to image and characterise the inflammation using other tools – for instance circulating biomarkers – potentially contributes a lot.
And I think where this field will go is to develop ways of characterising individual patients that will allow us to pair up, to match the diagnostics with specific treatments. Because if we don’t get to that stage then we really have no hope of delivering patients the type of specificity of therapy that they need.