Vulnerable Atherosclerotic Plaque [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2001; 29(6): 369-372

Vulnerable Atherosclerotic Plaque

Güneş AKGÜN1

In the pathophysiology of acute coronary syndrome (ACS) plaque vulnerability is much more iınportant than plaque size and stenosis severity. Plaque vulnerability is the consequence of inflammatory activity within the plaque. Rupture-prone vulnerable plaques are characterized by 1) a soft lipid core occupying at least 50% of the plaque v o l uın e, 2) a thin fibrous cap with reduced collagen content, 3) a high density of monocytes/macrophages , lyınphocytes, ınast cells, 4) low density of smooth muscle cells, 5) a high t issue facto1 content. Inflaınmatory cells (macrophages) produce specific metalloproteinases that degrade collagen within the fibrous cap. Macrophages and lyın phocytes also secrete cytokines that are cytotoxic for smooth muscle cells and activated macrophages can also induce smooth muscle cell apotos is by direct eel! contact. The result is a decrease in the number of smooth muscle cells and decreased collagen synthesis. The plaques with large soft lipid pool and a thin fibrous cap cannot resist local mechanical stresses and easily rupture with subsequent superimposed thrombosis and results in ACS. What causes inflammation in the atherosclerotic plaque? Where does the inflammatory stinıul us coıne from? At the present, the exact mechanism is not known; however, it is fair to state that oxidised LDL, oxidative stresses, low grade chronic infections and autoimmune respanses have a role in plaque activation. The evidence that in flaınmation is an essential feature of vulnerable plaque has !ed to intensive search for ischemic markers of plaque inflammation. High-sensitive -C reactive protein (hs CRP) has been found to have a strong correlation in the risk of a future acute cardiac event.

Keywords: Vulnerable plaque, inflammation, CRP

How to cite this article
Güneş AKGÜN. Vulnerable Atherosclerotic Plaque. Turk Kardiyol Dern Ars. 2001; 29(6): 369-372
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