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Coronary Artery Disease II: Pathophysiology01:26

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Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
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Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
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Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT01:25

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Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
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Atherosclerosis I: Introduction01:30

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Atherosclerosis is a progressive disorder characterized by the buildup of plaques on the arterial inner wall, causing them to narrow and harden over time. These plaques comprise lipids, calcium, blood components, carbohydrates, and fibrous tissue. The process primarily affects the intima of large and medium-sized arteries, reducing blood flow in any artery.Etiology and risk factorsThe cause of atherosclerosis is multifactorial, involving a complex interplay among endothelial injury, lipid...
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Coronary Artery Disease III: Clinical Manifestations01:30

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Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
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Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

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The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
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Coronary artery calcification: pathogenesis and prognostic implications.

Mahesh V Madhavan1, Madhusudhan Tarigopula2, Gary S Mintz2

  • 1New York-Presbyterian Hospital and the Columbia University Medical Center, New York, New York.

Journal of the American College of Cardiology
|February 18, 2014
PubMed
Summary

Coronary artery calcification (CAC) poses significant risks for cardiovascular events. Current treatments are ineffective, necessitating novel approaches to manage this condition and improve patient survival.

Keywords:
PCIcoronary artery calcificationcoronary artery disease

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Area of Science:

  • Cardiovascular Medicine
  • Vascular Biology
  • Biomedical Engineering

Background:

  • Coronary artery calcification (CAC) is a significant risk factor for adverse cardiovascular outcomes in general and high-risk populations.
  • The development of CAC shares pathological pathways with bone formation, with identified risk factors influencing its initiation and progression.
  • Existing medical therapies have proven unsuccessful in controlling CAC progression.

Purpose of the Study:

  • To review the current understanding of coronary artery calcification (CAC) pathogenesis and its clinical implications.
  • To evaluate the limitations of current therapeutic strategies for managing CAC.
  • To highlight the urgent need for innovative pharmacologic and device-based interventions for patients with CAC.

Main Methods:

  • Literature review of studies on coronary artery calcification (CAC) pathogenesis, risk factors, and treatment outcomes.
  • Analysis of clinical data regarding event-free survival in patients with CAC undergoing interventions.
  • Synthesis of information on the efficacy of current and emerging treatments for calcified coronary arteries.

Main Results:

  • Coronary artery calcification (CAC) is linked to poor prognosis, with reduced event-free survival after percutaneous coronary intervention (PCI) and bypass graft surgery.
  • Despite advancements like drug-eluting stents and plaque modification devices, adverse event rates remain high in calcified vessels.
  • Current medical therapies have failed to effectively control the initiation and progression of CAC.

Conclusions:

  • Patients with coronary artery calcification (CAC) face a poor prognosis, underscoring the limitations of current management strategies.
  • There is a critical need for the development of novel pharmacologic agents and device-based therapies to address CAC.
  • Innovative approaches are essential to improve outcomes and reduce the adverse event burden in individuals with significant coronary calcification.