Cardiovascular diseases are among the most important causes of death in The Netherlands. It is of great importance to be able to detect these diseases at an early stage. However, current methods that use classical risk factors such as cholesterol and blood pressure do not come up to the mark. We describe a novel method that assesses the cardiovascular risk in a simple manner. This refers to a device that has been developed in Groningen that allows the skin to fluoresce by using ultraviolet light, by which so called Advanced Glycation Endproducts (AGEs) can be measured: skin autofluorescence (AF). AGEs are formed at an high rate as a consequence of an excess in free oxygen radicals. This is generally referred to as oxidative stress and enhances the inflammatory process in the vascular wall that ultimately leads to cardiovascular disease. In this thesis we demonstrate that skin AF indeed increases with the progression of atherosclerosis. Skin AF is strongly related to markers of inflammation of the vascular wall and appears already to be elevated in healthy subjects with early signs of atherosclerosis, but more marked in patients with coronary artery disease or an acute myocardial infarction. In the latter, skin AF appears to be of prognostic value in predicting future complications. This thesis describes the role of skin AF in measuring oxidative stress and inflammation in patients with cardiovascular disease and in early detection and prevention of these conditions. By doing so, it might perhaps be possible to start therapy at an earlier stage in order to prevent complications in the future.
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