Beloqui, O. (Óscar)

Diez-Martinez, J. (Javier)

Universidad de Navarra

Atherosclerosis: Is it time for a new name?

Dadun, University of Navarra

José A. Páramo, Oscar Beloqui and Javier DiezAtherosclerosis: Is it Time for a New Name?Print ISSN: 0009-7322. Online ISSN: 1524-4539 Copyright © 2001 American Heart Association, Inc. All rights reserved.is published by the American Heart Association, 7272 Greenville Avenue, Dallas, TX 75231Circulation doi: 10.1161/01.CIR.104.7.e382001;104:e38Circulation.  http://circ.ahajournals.org/content/104/7/e38Wide Web at: The online version of this article, along with updated information and services, is located on the World   http://circ.ahajournals.org//subscriptions/is online at: Circulation  Information about subscribing to Subscriptions:   http://www.lww.com/reprints Information about reprints can be found online at: Reprints:  document. and Rights Question and Answer Permissionsthe middle column of the Web page under Services. Further information about this process is available in thethe online version of the published article for which permission is being requested is located, click Request Permissions in  can be obtained via RightsLink, a service of the Copyright Clearance Center, not the Editorial Office. OnceCirculation Requests for permissions to reproduce figures, tables, or portions of articles originally published inPermissions: at UNIVERSIDAD DE NAVARRA on July 2, 2014http://circ.ahajournals.org/Downloaded from Atherosclerosis: Is it Time for a New Name?To the Editor:Atherosclerosis, the leading cause of cardiovascular death inWestern countries, is an inflammatory disease.1 Evidence linkinginflammation to atherosclerosis stems from studies focusing onthe acute and chronic phases of coronary heart disease. Elevatedacute-phase reactants and cytokine production, activation of CD4and CD8 circulating lymphocytes, the presence of infiltratingmacrophages, expression of interferon-g, and neoangiogenesisall support the notion that atherosclerosis shares similar patho-physiological mechanisms with other inflammatory/autoimmunediseases.2 Moreover, the earliest type of atherosclerotic lesion(the fatty streak) is also an inflammatory lesion, consisting ofmacrophages and T-lymphocytes. In addition, circulating mark-ers of inflammation such as C-reactive protein recently havebeen found to be potential predictors of future cardiovascular andcerebrovascular events in patients with the disease.3,4 The studyreported by Muhlestein et al5 in the October 17, 2000, issue ofCirculation shows that high-sensitivity C-reactive protein canalso be predictive for mortality in patients with coronary arterydisease.In the light of these recent pathophysiological findings, wethink that time has come to reexamine the name for atheroscle-rosis and that a new name adapted to a more realistic scientificlanguage is required. In fact, arteriosclerosis is now seen as aprotective rather than a detrimental mechanism in the evolutionof the disease. Therefore, the undersigned authors propose thename of inflammatory and sclerosing arterial disease (ISAD),opening the possibility for other plausible nominations based onthe knowledge of the inflammatory mechanisms of this disease.José A. Páramo, MDOscar Beloqui, MDJavier Diez, MD, PhDHematology, Cardiovascular Division and Internal MedicineUniversity Clinic31080 Pamplona, Spain1. Ross R. Atherosclerosis: an inflammatory disease. N Engl J Med. 1999;340:115–126.2. Pasceri V, Yeh ETH. A tale of two diseases: atherosclerosis and rheu-matoid arthritis. Circulation. 1999;100:2124–2126.3. Lagrand WK, Visser CA, Hermens WT, et al. C-reactive protein ascardiovascular risk factor. Circulation. 1999;100:96–102.4. Ridker PM, Hennekens CH, Buring JE, et al. C-reactive protein and othermarkers of inflammation in the prediction of cardiovascular disease inwomen. N Engl J Med. 2000;342:836–843.5. Muhlestein JB, Horne BD, Carlquist JF, et al. Cytomegalovirus seropos-itivity and C-reactive protein have independent and combined predictivevalue form mortality in patients with angiographically demonstrated cor-onary artery disease. Circulation. 2000;102:1917–1923.1 at UNIVERSIDAD DE NAVARRA on July 2, 2014http://circ.ahajournals.org/Downloaded from 

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Atherosclerosis: Is it time for a new name?

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Universidad de Navarra

Dadun, University of Navarra