[Thrombus remodeling. Key factor in the progression of coronary atherosclerosis]

The mechanism of the progression of atherosclerosis involves the rupture of a plaque with thrombus formation, followed by an invasion of monocytes that induce the formation of tissue factor and a second thrombus. This is followed by activation of the smooth muscle cells of the arterial wall with formation of connective tissue that infiltrates both thrombi. We can try to prevent atherosclerosis progression by inhibiting thrombosis with an inhibitor of tissue factor, inhibiting the process of scarring with Rapamycin, or both. Nowadays, we can study these processes using highly sensitive techniques to monitorize the formation and evolution of the thrombus, and magnetic resonance imaging that allow us to study the growth of the connective tissue. With these techniques we can study the natural history of atherosclerosis and the efficacy of different drugs to prevent its progression.