Cardiology Myocardial ischemia and infarction Definition and pathophysiology Atherosclerosis is a chronic, inflammatory disease of the arterial wall in which lipid accumulation, vascular cell dysfunction…

…and extracellular matrix deposition, ultimately leading to the formation of atherosclerotic plaques [1] . While stable plaques are characterized by a thick fibrous cap and a…

…characterized by the gradual accumulation of inert cholesterol debris, modern vascular biology has redefined atherosclerosis as a dynamic, immune mediated fibroproliferative response to endothelial injury …

Myocardial ischemia and infarction Pharmacology & dosing Definition and pathophysiology Atherosclerosis and acute coronary syndromes have important inflammatory components. Inflammation contributes to atherothrombosis through activation of…

…burden of retained atherogenic particles accumulates over time, the probability of an acute atherosclerotic cardiovascular event increases. Non HDL Cholesterol Non HDL C is calculated…

…peripheral artery disease (PAD), and other manifestations of systemic atherosclerosis. The principal clinical concern is cerebral embolism or haemodynamic compromise leading to transient ischaemic attack…

…mortality. Cardiovascular conditions associated with obesity include hypertension, dyslipidaemia, coronary artery disease (CAD), atherosclerosis, heart failure (HF), atrial fibrillation and cardiovascular events. In clinical practice…

…and infarction Definition and therapeutic rationale Multivessel coronary artery disease (CAD) refers to clinically significant atherosclerotic disease affecting two or more major epicardial coronary arteries…

…and mortality, as well as limb complications. Atherosclerotic lesions generally affect large and medium sized arteries. Pathological features include plaque formation with calcium deposition, medial…

…abstinence from tobacco and ultimately from nicotine. Smoking is a major modifiable driver of atherosclerosis and cardiovascular disease. Its relationship with cardiovascular risk is nonlinear…

…Unprotected Left Main Disease : Increases complexity and risk. Peripheral Vascular Disease (PVD) : Indicates systemic atherosclerosis. Chronic Obstructive Pulmonary Disease (COPD) : Associated with higher perioperative risk…

…associated vasculitis, Takayasu arteritis, giant cell arteritis and APS may also be associated with premature atherosclerotic disease. In a large UK clinical database, autoimmune disease…

…completely different. It took roughly 50 years for researchers to finally conclude that high cholesterol levels caused coronary artery disease and atherosclerosis in general. This…

…adjacent reference segment presumed to be relatively normal. This assumption may be incorrect when atherosclerosis is diffuse, leading to underestimation of the overall disease burden…

Myocardial ischemia and infarction Definition and Pathophysiology Left main coronary artery disease (LMCAD) refers to atherosclerotic narrowing of the left main coronary artery, which supplies…

…and pathophysiology Lipid lowering therapy is a central component of cardiovascular prevention, particularly in patients with established atherosclerotic cardiovascular disease (ASCVD), chronic coronary syndrome (CCS)…

…β cell failure, endothelial dysfunction and atherosclerosis. Ectopic fat deposited around or within the heart and kidneys may exert direct compressive effects and releases additional…

…Non obstructive coronary atherosclerosis not associated with demonstrable ischaemia may therefore remain undetected unless CT based coronary calcium assessment or another anatomical technique is added…

…or coronary anatomy unsuitable for further intervention. In ANOCA/INOCA, coronary atherosclerosis, endothelial dysfunction, and distinct coronary functional abnormalities may produce ischaemia without an obstructive…

…atrial appendage, although competing mechanisms such as large artery atherosclerosis and small vessel disease may also contribute to stroke in patients with AF. Stroke risk…

…in lifetime cardiovascular disease (CVD) risk and approximately doubles cardiovascular risk on average. Its cardiovascular manifestations include atherosclerotic cardiovascular disease (ASCVD), coronary artery disease (CAD)…

…of underlying coronary artery disease (CAD) and structural cardiac abnormalities. Mechanisms involving reduced myocardial perfusion include fixed coronary atherosclerosis without plaque rupture, coronary artery spasm…

…Endothelial dysfunction, coronary microvascular disease and vasospasm may coexist with atherosclerosis or may be the dominant cause of ischaemia. Other mechanisms capable of obstructing coronary…

…propelled by a biologically active process. Risk factors for calcification overlap with risk factors for coronary heart disease (atherosclerosis). The average age at diagnosis of…

…coronary heart disease (CAD) and coronary artery disease (CHD) are synonyms. These terms refer to symptomatic coronary atherosclerosis. Traditional classification of coronary artery disease Traditionally…

…workload leads to increased oxygen demand but the stenosis limits the volume that can be delivered to the heart muscle supplied by the atherosclerotic artery…

…coronary heart disease (CAD) and coronary artery disease (CHD) are synonyms. These terms refer to symptomatic coronary atherosclerosis. Traditional classification of coronary artery disease Traditionally…

…classic aortic dissection, intramural haematoma (IMH), and penetrating atherosclerotic ulcer (PAU). Aortic dissection accounts for approximately 80%–90% of acute aortic syndromes, IMH for approximately…

…modifiable cardiovascular risk factor in older adults. It contributes to vascular injury, accelerates atherosclerosis, increases myocardial oxygen demand, and may worsen ischemia in patients with…

…been identified as important risk factors. Severe atherosclerosis of the axillary or subclavian arteries may increase the risk of embolization. Risk assessment should be individualized…

…CMD; epicardial coronary vasospasm; microvascular spasm; endothelial dysfunction; concealed diffuse atherosclerosis; myocardial bridging; myocardial metabolic abnormalities; and abnormal pain perception in patients without demonstrable ischaemia…

…sudden cardiac death. SCAD differs pathogenetically from atherosclerotic type 1 MI. It is an infrequent cause of ACS overall but represents a substantial proportion of…

…performing an ultrasound is to scrutinize potential cardiac sources of emboli and to evaluate the carotid and cerebral arteries. Ultrasound may reveal atherosclerotic plaques, thrombi…

…lower sensitivity and specificity in women. This may be due to the following: Atherosclerosis is generally less severe in women. Women tend to have more…

…Registry data, such as those from the Framingham Heart Study and the Atherosclerosis Risk in Communities (ARIC) study, highlight a shifting demographic profile in incident…

…In stable angina pectoris, there are atherosclerotic plaques which limit coronary blood flow and cause symptoms during increased myocardial workload (exercise). The more severe the…

Cardiology Pharmacology & dosing Definition and Therapeutic Rationale Hypertension is a major risk factor for atherosclerotic cardiovascular disease and contributes to microvascular and macrovascular complications. It…

…dissection is a major form of acute aortic syndrome (AAS), alongside intramural haematoma, penetrating atherosclerotic ulcer, aortic pseudoaneurysm and traumatic aortic injury. In classic dissection…

…only in claudication, but before every compression treatment of a leg ulcer and as a risk marker in diabetes and known atherosclerotic disease. An ABI…

…AAA may also be associated with mesenteric ischemia or acute renal failure, either through atherosclerotic or atherothrombotic disease. Mural thrombus may predispose to peripheral embolization…

…cardiovascular death, and progression of atherosclerotic disease in patients with established coronary or other atherosclerotic vascular disease. Antiplatelet therapy is a central component because platelet…

…Myocardial ischemia and infarction Definition and Pathophysiology Coronary artery calcium (CAC) scoring is a non invasive method for detecting and quantifying calcified coronary atherosclerotic plaque…

…tomographic angiography (CCTA) is a non invasive anatomical examination that depicts the coronary arterial lumen, atherosclerotic plaque, and the severity and distribution of coronary stenosis…

…characterized by persistently elevated plasma low density lipoprotein cholesterol (LDL C) from early life and a consequent excess risk of premature atherosclerotic cardiovascular disease (ASCVD)…

…is the principal therapeutic target in lipid management because LDL and other apolipoprotein B containing lipoproteins play a causal role in atherosclerotic cardiovascular disease (ASCVD)…

…severe, myocardial necrosis. It most commonly reflects atherothrombosis: disruption of an atherosclerotic plaque followed by platelet activation and coagulation, with formation of an intraluminal thrombus…

…infarction Classification, diagnosis and definitions of acute coronary syndromes (ACS) and acute myocardial infarction (AMI) Acute coronary syndromes occur when atherosclerotic plaques disrupt, resulting in…

…severe complication of coronary artery disease. The most common initiating mechanism is rupture or erosion of a vulnerable (unstable) atherosclerotic coronary plaque. Upon such damage…

…predictors in prediction models. Targeting risk factors has been very successful in the primary and secondary prevention of atherosclerotic cardiovascular disease, both at the population…

…other platelet pathways. The distinction between primary and secondary prevention is fundamental: Primary prevention refers to individuals without established atherosclerotic cardiovascular disease (ASCVD), coronary artery…

…therapy 18% Fixed dose combination with ezetimibe 38% Pooled analyses across different background therapies 17%–25% In patients with atherosclerotic vascular disease or familial hypercholesterolaemia…

…They supersede risk models that estimate cardiovascular mortality alone because non fatal events constitute an important component of the overall burden of atherosclerotic cardiovascular disease…

…disease may be obstructive or non obstructive. Atherosclerotic plaque accumulation in the epicardial arteries is a major pathological substrate, but ischaemia may also result from…

…rehabilitation, ablative or surgical interventions The test does not define the structure or composition of coronary atherosclerotic plaque, identify plaques at high risk of rupture…

…chronic coronary syndrome, acute coronary syndrome (ACS), atherosclerotic peripheral arterial disease, and other very high risk settings described in the source material. The statin should…

…dL ( 5.6 mmol/L) Triglyceride rich lipoproteins, remnant lipoproteins and insulin resistance are associated with atherosclerotic cardiovascular disease (ASCVD), particularly in peripheral arterial disease…

…when additional LDL C reduction is required, including in patients with atherosclerotic cardiovascular disease (ASCVD) or heterozygous familial hypercholesterolaemia. The broader therapeutic principle is that…

…of cholesterol than LDL cholesterol. Clinical implications High Lp(a) is independently associated with first and recurrent atherosclerotic cardiovascular disease events. The strongest observed associations…

…with ezetimibe where appropriate. Established clinical atherosclerotic cardiovascular disease (ASCVD) and FH are principal settings in which these drugs have received approval. In chronic coronary…

…anatomical considerations warrant it. The contemporary diagnostic strategy also recognises that symptoms of myocardial ischaemia may arise from obstructive atherosclerotic CAD, coronary microvascular dysfunction or…