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Atherosclerosis (ASVD) remains a leading driver of cardiovascular disease (CVD), a global health challenge that claims millions of lives each year. A 2022 study published in Circulation demonstrated that earlier LDL-C reduction leads to compounded cardiovascular benefits over time. But what if prevention could rewrite the narrative?
Thus, angiography may be fairly accurate in determining lumen size, but it will not detect the “volume” of atherosclerosis present. It is not small but rather large plaques, which may not be producing significant stenosis, that undergo rupture with acute occlusive thrombosis, resulting in myocardial infarction and other ischemic events.
MINOCA may be due to: coronary spasm, coronary microvascular dysfunction, plaque disruption, spontaneous coronary thrombosis/emboli , and coronary dissection; myocardial disorders, including myocarditis, takotsubo cardiomyopathy, and other cardiomyopathies. See "Mechanisms of acute coronary syndromes related to atherosclerosis".)
Nonobstructive coronary disease by coronary angiography should be differentiated between patients with normal coronary arteries and minimal luminal irregularities (less than 30% stenosis) and mild to moderate coronary atherosclerosis (30% to less than 50%). FFR can be useful.
MINOCA may be due to: coronary spasm, coronary microvascular dysfunction, plaque disruption, spontaneous coronary thrombosis/emboli , and coronary dissection. link] We know that most type 1 acute MI due to plaque rupture and thrombosis occurs in lesions that are less than 50% (see Libby reference).
1,6 Until recently atherosclerosis has been thought of as the result of passive lipid accumulation in the vessel wall. However, the development of atherosclerosis is now known to be much more complex, with a key role for immune cells and inflammation in conjunction with hyperlipidemia and elevated LDL levels.7
BACKGROUND:Sex-specific differences in plaque composition and instability underscore the need to explore circulating markers for better prediction of high-risk plaques. Antagonistic interactions between sex and white blood cell (WBC) counts, basophil-to-WBC ratio, and platelet counts influenced plaque instability.
Atherosclerosis & Arterial Diseases Peripheral Artery Disease (PAD) : A blockage in your legs. Total loss of circulation can lead to gangrene and loss of a limb. Deep Vein Thrombosis (DVT) : A blood clot occurring in a deep vein. Depending on the condition, they may also only affect specific parts of your body.
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