Case Report: Coronary plaque rupture following glucocorticoid tapering in a high-risk CAD patient with immune nephritis: mechanistic insights and clinical implications

This case underscores the mechanistic duality of GCs. Chronic GC therapy suppresses pro-inflammatory cytokines and macrophage activity, stabilizing plaques by reducing oxidized LDL uptake. However, abrupt tapering may trigger rebound vascular inflammation, destabilizing high-risk lesions. OCT imaging proved critical in identifying vulnerable plaque morphology, emphasizing its role in guiding urgent interventions.