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[Acute coronary syndromes]
1Kumamoto Aging Research Institute.
Insights
Acute coronary syndromes, including unstable angina and myocardial infarction, stem from plaque rupture and blood clots. Managing atherosclerosis risk factors is key to preventing these life-threatening cardiac events.
Area of Science:
- Cardiovascular Medicine
- Pathology
- Biochemistry
Context:
- Acute coronary syndromes (ACS) encompass unstable angina, myocardial infarction, and sudden cardiac death.
- These conditions are frequently linked to the thrombotic occlusion of coronary arteries.
- Plaque disruption in atherosclerotic arteries is a primary cause of ACS.
Purpose:
- To define acute coronary syndromes and their underlying pathological mechanisms.
- To highlight the characteristics of vulnerable atherosclerotic plaques.
- To emphasize the importance of risk factor management in ACS prevention.
Summary:
- ACS result from atherosclerotic plaque rupture and subsequent coronary artery thrombosis.
- Vulnerable plaques feature thin fibrous caps, large lipid cores, and inflammatory cell infiltration.
- ACS prevalence is higher in arteries with less significant organic stenosis compared to those with higher stenosis.
Impact:
- Understanding plaque vulnerability aids in identifying high-risk individuals.
- Effective control of atherosclerosis risk factors is crucial for preventing ACS.
- This knowledge supports targeted therapeutic strategies for cardiovascular disease management.
Abstract:
Recently, unstable angina, acute myocardial infarction and sudden cardiac death have often been put together under the name 'acute coronary syndromes', because almost all of these conditions have been shown to be caused by thrombotic occlusion of a coronary artery following atherosclerotic plaque disruption. Acute coronary syndromes occur more frequently in the coronary arteries with no significant organic stenosis than in those with a higher degree of stenosis. A plaque prone to disruption has a thin fibrous cap, a large lipid core and increased infiltration of macrophages and T lymphocytes. The elimination or control of risk factors for atherosclerosis such as dyslipidemia, hypertension, smoking, diabetes mellitus, obesity and lack of exercise is essential for the prevention of acute coronary syndromes.