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[Risk factors and prevention of acute coronary syndrome]
Insights
Preventing acute coronary syndromes (ACS) involves managing traditional risk factors like hypertension and dislipidemia, alongside emerging factors such as inflammation. Plaque stabilization is a key therapeutic strategy for ACS prevention.
Area of Science:
- Cardiology
- Vascular Biology
- Preventive Medicine
Context:
- Acute coronary syndromes (ACS) arise from atherosclerotic plaque rupture and subsequent thrombosis.
- Plaque stabilization is a critical therapeutic target for ACS prevention.
- Traditional and emerging risk factors contribute to ACS development.
Purpose:
- To review the pathophysiology of ACS and the role of plaque stabilization.
- To identify established and novel risk factors for coronary events.
- To discuss the impact of risk factor management on cardiovascular outcomes.
Summary:
- ACS, including myocardial infarction, results from disrupted atherosclerotic plaques.
- Key risk factors include age, smoking, hypertension, dislipidemia, diabetes, obesity, and stress.
- Emerging factors like high homocysteine, inflammation, and infection also play a role.
Impact:
- Blood pressure and cholesterol control significantly reduce coronary event risk and mortality.
- Smoking cessation, moderate alcohol intake, aspirin, and hormone therapy offer proven benefits.
- Effective management of modifiable risk factors is essential for cardiovascular health.
Abstract:
Acute coronary syndromes (ACS) such as unstable angina, myocardial infarction, or sudden ischemic death evolve from coronary thrombosis consequence of atherosclerotic plaque disruption. Plaque stabilization is an important therapeutic strategy in the prevention of ACS. Coronary risk factors include age, male sex, cigarette smoking, hypertension, dislipidemia, diabetes mellitus, insulin resistance and/or hyper insulinemia, obesity, sedentary lifestyle, stress, and the morning surge of sympathetic activity. New risk factors are emerging such as high homocystein, inflammation, and some kinds of infection. Control of blood pressure and cholesterol clearly reduce the risk of coronary events and mortality although the effects of antihypertensive therapy have been less than expected. The benefits of smoking cessation, moderate alcohol consumption, low-dose aspirin prophylaxis, estrogen-replacement therapy in postmenoposal women have also been shown.