{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T17:54:19Z","timestamp":1793555659677,"version":"4.5.0"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:00:00Z","timestamp":1773273600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a systemic autoimmune small- to medium-vessel vasculitis. Reports of rapidly progressive left main\/left anterior descending (LM\/LAD) disease under normolipidemic conditions with parallel coronary\u2013aortic progression are scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>We report a case of perinuclear antineutrophil cytoplasmic antibody (p-ANCA) and myeloperoxidase (MPO)\u2013positive ANCA-associated vasculitis (AAV) in which, despite persistently normal lipid levels, the coronary arteries developed rapidly progressive stenosis and occlusion within one year. Intravascular ultrasound (IVUS) revealed concentric thickening of the coronary arterial wall characterized predominantly by soft plaques with minimal calcification, which was consistent with an inflammation-driven remodeling phenotype. Because the admission electrocardiogram (ECG) revealed an ST-segment elevation myocardial infarction (STEMI)-equivalent pattern (aVR ST elevation with diffuse ST depression), the patient was treated for acute myocardial infarction, and urgent LM-to-LAD drug-eluting stent (DES) implantation was performed. During a four-month follow-up after discharge, no recurrent angina or ischemic events were reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In a p-ANCA\/MPO-positive AAV patient with sustained normolipidemia, we observed rapidly progressive LM\/LAD disease occurring in parallel with aortic involvement, which was consistent with an inflammation-driven coronary phenotype that precipitated acute coronary syndrome. Integrating sequential coronary\u2013aortic imaging with inflammatory biomarker surveillance and individualized immunomodulatory and antithrombotic strategies may enable earlier risk detection and optimize outcomes in patients with AAV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1736895","type":"journal-article","created":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T06:48:25Z","timestamp":1773298105000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case Report: Rapid progression of inflammation-driven coronary artery lesions in a normolipidemic patient with ANCA-associated vasculitis complicated by Stanford type A aortic dissection"],"prefix":"10.3389","volume":"17","author":[{"given":"Guangzhen","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Cardiology, Shandong Provincial Hospital Affiliated with Shandong First Medical University","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoting","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Shandong Provincial Hospital Affiliated with Shandong First Medical University","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinye","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Shandong Provincial Hospital Affiliated with Shandong First Medical University","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Zhuang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Shandong Provincial Hospital Affiliated with Shandong First Medical University","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gang","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Shandong Provincial Hospital Affiliated with Shandong First Medical University","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1038\/s41572-020-0204-y","article-title":"ANCA-associated vasculitis","volume":"6","author":"Kitching","year":"2020","journal-title":"Nat Rev Dis Primers"},{"key":"B2","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1016\/j.carrev.2023.07.012","article-title":"Correspondence regarding a published study: Inflammation and cholesterol as predictors of cardiovascular events among patients receiving statin therapy: a collaborative analysis of three randomized 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