(Circulation. 2001;104:365.)
© 2001 American Heart Association, Inc.
Current Perspectives |
Current Concepts of the Pathogenesis of the Acute Coronary Syndromes
From Leducq Center for Cardiovascular Research, Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Mass.
Correspondence to Peter Libby, MD, Cardiovascular Division, Department of Medicine, 221 Longwood Ave, LMRC 307, Boston, MA 02115. E-mail plibby@rics.bwh.harvard.edu
Key Words: angiotensin • myocardial infarction • atherosclerosis • inflammation • metalloproteinases • thrombosis
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Introduction |
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The last decade has witnessed a major reassessment of our perceptions about the acute coronary syndromes. Today, we recognize that thrombosis underlies most acute complications of atherosclerosis, notably unstable angina and acute myocardial infarction. A consensus has emerged that inflammation plays a decisive role in the pathophysiology of these acute thrombotic events (Figure 1). Knowledge of the underlying mechanisms has increased substantially since this topic was last reviewed in these pages 6 years ago. The present article provides an update of this rapidly moving field.
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I.-K. Jang, G. J. Tearney, B. MacNeill, M. Takano, F. Moselewski, N. Iftima, M. Shishkov, S. Houser, H. T. Aretz, E. F. Halpern, et al. In Vivo Characterization of Coronary Atherosclerotic Plaque by Use of Optical Coherence Tomography Circulation, March 29, 2005; 111(12): 1551 - 1555. [Abstract] [Full Text] [PDF]
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S. D. Katz, K. Hryniewicz, I. Hriljac, K. Balidemaj, C. Dimayuga, A. Hudaihed, and A. Yasskiy Vascular Endothelial Dysfunction and Mortality Risk in Patients With Chronic Heart Failure Circulation, January 25, 2005; 111(3): 310 - 314. [Abstract] [Full Text] [PDF]
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 K. W. Lee, G. Y. H. Lip, M. Tayebjee, W. Foster, and A. D. Blann Circulating endothelial cells, von Willebrand factor, interleukin-6, and prognosis in patients with acute coronary syndromes Blood, January 15, 2005; 105(2): 526 - 532. [Abstract] [Full Text] [PDF]
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A. C. Ferreira, A. A. Peter, A. J. Mendez, J. J. Jimenez, L. M. Mauro, J. A. Chirinos, R. Ghany, S. Virani, S. Garcia, L. L. Horstman, et al. Postprandial Hypertriglyceridemia Increases Circulating Levels of Endothelial Cell Microparticles Circulation, December 7, 2004; 110(23): 3599 - 3603. [Abstract] [Full Text] [PDF]
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Q. Cai, L. Lanting, and R. Natarajan Interaction of Monocytes With Vascular Smooth Muscle Cells Regulates Monocyte Survival and Differentiation Through Distinct Pathways Arterioscler Thromb Vasc Biol, December 1, 2004; 24(12): 2263 - 2270. [Abstract] [Full Text] [PDF]
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M. Ishibashi, K. Egashira, Q. Zhao, K.-i. Hiasa, K. Ohtani, Y. Ihara, I. F. Charo, S. Kura, T. Tsuzuki, A. Takeshita, et al. Bone Marrow-Derived Monocyte Chemoattractant Protein-1 Receptor CCR2 Is Critical in Angiotensin II-Induced Acceleration of Atherosclerosis and Aneurysm Formation in Hypercholesterolemic Mice Arterioscler Thromb Vasc Biol, November 1, 2004; 24(11): e174 - e178. [Abstract] [Full Text] [PDF]
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 J.-B. Wasserfallen, A. Berger, P. Eckert, J.-C. Stauffer, J. Schlaepfer, D. Gillis, J. Cornuz, M.-D. Schaller, L. Kappenberger, and B. Yersin Impact of medical practice guidelines on the assessment of patients with acute coronary syndrome without persistent ST segment elevation Int. J. Qual. Health Care, October 1, 2004; 16(5): 383 - 389. [Abstract] [Full Text] [PDF]
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A. Nemmar, P. H.M. Hoet, J. Vermylen, B. Nemery, and M. F. Hoylaerts Pharmacological Stabilization of Mast Cells Abrogates Late Thrombotic Events Induced by Diesel Exhaust Particles in Hamsters Circulation, September 21, 2004; 110(12): 1670 - 1677. [Abstract] [Full Text] [PDF]
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 A. Recinos III, B. K. Carr, D. B. Bartos, I. Boldogh, J. R. Carmical, L. M. Belalcazar, and A. R. Brasier Liver gene expression associated with diet and lesion development in atherosclerosis-prone mice: induction of components of alternative complement pathway Physiol Genomics, September 16, 2004; 19(1): 131 - 142. [Abstract] [Full Text] [PDF]
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H. S. Lim, R. J. MacFadyen, and G. Y. H. Lip Diabetes Mellitus, the Renin-Angiotensin-Aldosterone System, and the Heart Arch Intern Med, September 13, 2004; 164(16): 1737 - 1748. [Abstract] [Full Text] [PDF]
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B. D. MacNeill, I.-K. Jang, B. E. Bouma, N. Iftimia, M. Takano, H. Yabushita, M. Shishkov, C. R. Kauffman, S. L. Houser, H.T. Aretz, et al. Focal and multi-focal plaque macrophage distributions in patients with acute and stable presentations of coronary artery disease J. Am. Coll. Cardiol., September 1, 2004; 44(5): 972 - 979. [Abstract] [Full Text] [PDF]
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E. M. Scott, R. A.S. Ariens, and P. J. Grant Genetic and Environmental Determinants of Fibrin Structure and Function: Relevance to Clinical Disease Arterioscler Thromb Vasc Biol, September 1, 2004; 24(9): 1558 - 1566. [Abstract] [Full Text] [PDF]
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Q. Zhao, M. Ishibashi, K.-i. Hiasa, C. Tan, A. Takeshita, and K. Egashira Essential Role of Vascular Endothelial Growth Factor in Angiotensin II-Induced Vascular Inflammation and Remodeling Hypertension, September 1, 2004; 44(3): 264 - 270. [Abstract] [Full Text] [PDF]
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 T. M. Doherty, L. A. Fitzpatrick, D. Inoue, J.-H. Qiao, M. C. Fishbein, R. C. Detrano, P. K. Shah, and T. B. Rajavashisth Molecular, Endocrine, and Genetic Mechanisms of Arterial Calcification Endocr. Rev., August 1, 2004; 25(4): 629 - 672. [Abstract] [Full Text] [PDF]
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S. Kitamoto, K. Nakano, Y. Hirouchi, Y. Kohjimoto, S. Kitajima, M. Usui, S. Inoue, and K. Egashira Cholesterol-Lowering Independent Regression and Stabilization of Atherosclerotic Lesions by Pravastatin and by Antimonocyte Chemoattractant Protein-1 Therapy in Nonhuman Primates Arterioscler Thromb Vasc Biol, August 1, 2004; 24(8): 1522 - 1528. [Abstract] [Full Text] [PDF]
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S. Kinlay, G. G. Schwartz, A. G. Olsson, N. Rifai, W. J. Sasiela, M. Szarek, P. Ganz, P. Libby, and for the Myocardial Ischemia Reduction with Aggress Effect of Atorvastatin on Risk of Recurrent Cardiovascular Events After an Acute Coronary Syndrome Associated With High Soluble CD40 Ligand in the Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) Study Circulation, July 27, 2004; 110(4): 386 - 391. [Abstract] [Full Text] [PDF]
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 L. L. Stoll, G. M. Denning, W.-G. Li, J. B. Rice, A. L. Harrelson, S. A. Romig, S. T. Gunnlaugsson, F. J. Miller Jr, and N. L. Weintraub Regulation of Endotoxin-Induced Proinflammatory Activation in Human Coronary Artery Cells: Expression of Functional Membrane-Bound CD14 by Human Coronary Artery Smooth Muscle Cells J. Immunol., July 15, 2004; 173(2): 1336 - 1343. [Abstract] [Full Text] [PDF]
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