Factors determining and prevention of atherosclerotic plaque rupture

Stable atherosclerotic plaques may become unsuitable at any time during the course of the disease. Unstable atherosclerotic plaques often rupture resulting in platelet activation and intravascular thrombosis which may lead to acute ischaemic syndromes. Factors which contribute to the plaque's instability are the amount of lipids contained in the central core of the plaque, the weakening of the fibrous cap of the plaque and pulsative stresses. Aggressive cholesterol reduction and control of factors which produce endothelial injury and contribute to the development and progression of atherosclerosis such as smoking and hypertension, and prevention of intravascular thrombosis such as aspirin, may prevent plaque rupture, intravascular thrombosis and acute ischaemic syndromes.