Arteriosklerose der Koronararterien und Plaque-Progression

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• 作者：PD Dr. med. Jeremias Wohlschlaeger ; S. Bertram ; D. Theegarten ; T. Hager ; H.A. Baba
• 关键词：Koronararteriensklerose ; Instabile Plaque ; Plaque ; Ruptur ; Thrombose ; Akutes Koronarsyndrom ; Coronary atherosclerosis ; Vulnerable plaque ; Plaque rupture ; Thrombosis ; Acute coronary syndrome
• 刊名：Herz
• 出版年：2015
• 出版时间：September 2015
• 年：2015
• 卷：40
• 期：6
• 页码：837-844
• 全文大小：1,178 KB
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• 作者单位：PD Dr. med. Jeremias Wohlschlaeger (1) (2)
  S. Bertram (1)
  D. Theegarten (1)
  T. Hager (1)
  H.A. Baba (1)
  
  1. Institut f眉r Pathologie, Universit盲tsklinik Essen, Essen, Deutschland
  2. Institut f眉r Pathologie, Evang.-luth. Diakonissenanstalt zu Flensburg, Flensburg, Deutschland
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Cardiology
  
• 出版者：Urban & Vogel
• ISSN：1615-6692

文摘

Atherosclerosis causes clinical symptoms through luminal narrowing by stenosis or by precipitating thrombi that obstruct blood flow to the myocardium (coronary artery disease), central nervous system (ischemic stroke) or lower extremities (peripheral vascular disease). The most common of these manifestations of atherosclerosis is coronary artery disease, clinically presenting as either stable angina or acute coronary syndromes. Atherosclerosis is a mainly lipoprotein-driven disease, which is associated with the formation of atherosclerotic plaques at specific sites of the vascular system through inflammation, necrosis, fibrosis and calcification. In most cases, plaque rupture of a so-called thin-cap fibroatheroma leads to contact of the necrotic core material of the underlying atherosclerotic plaque with blood, resulting in the formation of a thrombus with acute occlusion of the affected (coronary) artery. The atherosclerotic lesions that can cause acute coronary syndromes by formation of a thrombotic occlusion encompass (1) thin-cap fibroatheroma, (2) plaque erosion and (3) so-called calcified nodules in calcified and tortuous arteries of aged individuals. The underlying pathomechanisms remain incompletely understood so far. In this review, the mechanisms of atherosclerotic plaque initiation and progression are discussed. Keywords Coronary atherosclerosis Vulnerable plaque Plaque rupture Thrombosis Acute coronary syndrome