[The (un)predictability of coronary atherosclerosis]

Area of Science:

• Cardiovascular Medicine
• Pathology

Background:

• Coronary atherosclerosis is a prevalent disease characterized by plaque formation within coronary arteries.
• Plaques can lead to severe outcomes like myocardial infarction, but disease progression is highly variable and difficult to predict.
• Atherosclerosis is not uniformly progressive; it exhibits periods of stability and regression, a phenomenon termed periodicity.

Purpose of the Study:

• To review the known processes involved in atherosclerotic plaque development and increasing vulnerability.
• To highlight the current lack of understanding regarding atherosclerosis periodicity.
• To emphasize the potential therapeutic relevance of gaining further insight into this periodicity.

Main Methods:

• Review of existing literature on the biological processes underlying atherosclerosis.
• Discussion of factors contributing to plaque development and vulnerability.
• Analysis of the concept of atherosclerosis periodicity.

Main Results:

• Several biological processes contribute to atherosclerotic plaque development and vulnerability.
• Atherosclerosis progression is characterized by periods of stability and regression, indicating a non-linear course.
• The underlying mechanisms driving atherosclerosis periodicity remain largely unexplained.

Conclusions:

• Understanding atherosclerosis periodicity is crucial for developing more effective therapeutic strategies.
• Current treatments, primarily LDL-cholesterol reduction and lifestyle changes, may benefit from insights into disease dynamics.
• Further research into the mechanisms of plaque stability and regression is warranted.