Document Detail


Atherogenesis and thrombosis: mechanisms, pathogenesis, and therapeutic implications.
MedLine Citation:
PMID:  1553879     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Although the mortality rate from coronary heart disease (CHD) has declined by almost 50% during the past 25 years, CHD remains the leading cause of death in the United States and is responsible for more than 500,000 deaths annually. The underlying cause of CHD is coronary atherosclerosis. Although the intact intima is highly resistant to thrombus formation, when injury occurs, even superficial, a sequence of reactions is initiated--platelet aggregation, macrophage accumulation, intimal smooth muscle proliferation, fibrous tissue proliferation, and lipid accumulation--that result in the development of obstructive atheroma. Repeat intimal injury and cycling of this process lead to continued progression of the atheroma and coronary artery occlusion. Unstable angina and acute myocardial infarction appear to result from rupture of an atherosclerotic plaque, hemorrhage into the plaque, and luminal thrombosis. The cause of plaque rupture is unknown and may result from normal hemodynamic forces when the fibrous cap of an atheroma has become severely attenuated and fragile. Based on the pathogenesis of chronic atherosclerosis and acute rapid atheroma progression, several therapeutic options become evident. These include antiplatelet, anticoagulant, and thrombolytic therapies, as well as the possibility of arrest and reversal of atherosclerosis in some patients.
Authors:
L T Clark
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  American heart journal     Volume:  123     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1992 Apr 
Date Detail:
Created Date:  1992-04-30     Completed Date:  1992-04-30     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1106-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, State University of New York Health Science Center, Brooklyn 11203.
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MeSH Terms
Descriptor/Qualifier:
Coronary Artery Disease* / complications,  etiology,  therapy
Coronary Disease / etiology*,  therapy
Coronary Thrombosis* / complications,  etiology,  therapy
Death, Sudden, Cardiac / etiology
Humans

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