Journal article

TOWARD THE QUIESCENT CORONARY PLAQUE

AI MACISAAC, JD THOMAS, EJ TOPOL

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | ELSEVIER SCIENCE INC | Published : 1993

Abstract

The treatment of coronary atherosclerosis requires an understanding of the pathophysiology of plaque rupture. The rupture of lipid-laden, macrophage-rich plaques initiates unstable angina, acute myocardial infarction and sudden cardiac death. Plaque rupture occurs when the circumferential tension on a plaque exceeds its tensile strength, an event that cannot be predicted by coronary angiography. The incidence of plaque rupture appears to be reduced in patients receiving cholesterol-lowering therapy, beta-adrenergic blocking agents and, possibly, angiotensin-converting enzyme inhibitors and antioxidants. Not all ruptured coronary plaques produce an acute coronary syndrome. The consequences of..

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