Dr Rajiv Desai

An Educational Blog

VULNERABLE PLAQUE

Vulnerable Plaque: ____ ____ Prologue: Worldwide more than 17 million people die every year from cardiovascular disease (CVD) with this number projected to increase to over 23 million by 2030. The vast majority of acute ischemic vascular events occur in relation to an underlying atherosclerotic plaque. Atherosclerotic plaque represents the hallmark lesion of atherosclerosis. Plaque rupture is the dominant initiating event, responsible for 60–70% of acute coronary syndromes (ACS), while plaque erosion is responsible for most of the remainder. Irrespective of the mechanism, the consequence is exposure of a thrombogenic substrate to circulating blood. This in turn triggers platelet aggregation and the coagulation cascade which compromises vascular blood flow resulting in downstream end-organ ischemia and infarction. These events occur abruptly and often without warning. Despite major advances in treatment of coronary artery disease patients, a large number of victims of the disease who are apparently healthy die suddenly without prior […]

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