ATHEROSCLEROTIC PLAQUES IN HUMAN CORONARY ARTERIES

Abstract

Atherosclerosis or coronary artery disease (CAD) is the most common form of cardiovascular disease (CVD) where the main component is lipid accumulation and inflammation of the large arteries, which eventually may lead to its clinical complications, myocardial infarction (MI) and stroke. As a disease of slow progression, clinically significant atherosclerosis occurs primarily in older individuals and, despite declining incidence in some countries, remains the leading cause of mortality worldwide. Atherosclerotic lesions are characterized by a lifetime long accumulation and transformation of lipids, inflammatory cells, smooth muscle cells, and necrotic cell debris in the intimal space underneath a monolayer of endothelial cells (ECs) that line the interior vessel wall. Typically, lesion growth can reduce blood flow in the lumen by >50% and may cause angina particularly during exercise or stress. Lesions can become unstable and rupture, particularly if they have fatty and inflammatory composition. If this occurs in the coronary arteries, it can result in a local clot that may completely obstruct the blood flow to cause an MI. Alternatively, the clot can escape the heart and travel to the brain where it may cause a stroke.