Atherosclerosis: A Pathologist's Perspective.

Area of Science:

• Cardiovascular Pathology
• Immunopathology
• Arterial Wall Biology

Background:

• Atherosclerosis is a leading global cause of cardiovascular morbidity and mortality.
• It's a complex arterial disease involving inflammation, lipid changes, and cellular alterations.
• Despite advances, it remains a significant health challenge worldwide.

Purpose of the Study:

• To provide a comprehensive pathological overview of atherosclerosis.
• To integrate classical morphology with modern immunopathology and plaque instability concepts.
• To highlight pathology's role in refining risk assessment and treatment.

Main Methods:

• Review of arterial wall structure and atherosclerosis pathogenesis.
• Analysis of histopathological classification systems (AHA, Virmani).
• Emphasis on plaque instability features and immunohistochemical markers.

Main Results:

• Plaque instability features (cap thinning, inflammation, core expansion) predict outcomes, not just stenosis.
• Immunohistochemistry aids in defining plaque biology and local balance.
• Pathological insights link to risk assessment, imaging, and therapies.

Conclusions:

• Pathology is crucial for understanding atherosclerosis as an active disease.
• Refining concepts of plaque instability is essential.
• Integrating histopathology with molecular and clinical data advances precision medicine for atherosclerotic cardiovascular disease.