…Coronary arterial thrombi are predominantly platelet rich because they form under high shear conditions. Disruption of an atherosclerotic plaque or injury associated with PCI exposes…

… doubling the dose produces an additional reduction of approximately 6%. Clinical indications and treatment goals Established atherosclerotic cardiovascular disease Patients with established ASCVD are at…

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…

…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…

…to evaluate the carotid and cerebral arteries. Ultrasound may reveal atherosclerotic plaques, thrombi, occlusions, and dissections. Stroke is subdivided into hemorrhagic stroke (13% of all…

Cardiology Coronary Atherosclerosis Coronary atherosclerosis is a chronic, progressive, and highly complex lipid driven inflammatory disease of the arterial intima that serves as the fundamental…

…Atherothrombosis Coronary atherosclerosis is a chronic, progressive, and highly dynamic inflammatory disease of the arterial wall. It is characterized by the subendothelial accumulation of apolipoprotein…

…terms refer to symptomatic coronary atherosclerosis. Traditional classification of coronary artery disease Traditionally, coronary artery disease has been classified into the following three syndromes: Stable…

…terms refer to symptomatic coronary atherosclerosis. Traditional classification of coronary artery disease Traditionally, coronary artery disease has been classified into the following three syndromes: Stable…

…other atherosclerotic disease; diabetes and other cardiovascular risk factors; smoking, hypertension, hypercholesterolaemia, and sedentary behaviour; family history, particularly in the broader assessment of peripheral arterial…

…with stable or chronic atherosclerotic coronary disease, many of whom have a previous acute coronary syndrome. The available evidence supports consideration of low dose colchicine…

…when atherosclerosis is diffuse, leading to underestimation of the overall disease burden. Angiography also provides limited information about plaque composition, vulnerability and the risk of…

…modifiable driver of atherosclerosis and cardiovascular disease. Its relationship with cardiovascular risk is nonlinear: even light smoking carries a substantial proportion of the excess ischaemic…

…endothelial dysfunction and atherosclerosis. Ectopic fat deposited around or within the heart and kidneys may exert direct compressive effects and releases additional inflammatory and profibrotic…

…caused by stenosis or occlusion of the aorta or arteries supplying the limbs. In adults over 40 years of age, atherosclerosis is the predominant cause…

…risk assessment. Key Variables in SYNTAX Score II Anatomical SYNTAX Score : Derived from the original SYNTAX Score, which evaluates the complexity of coronary lesions. Clinical…

…in atherosclerotic cardiovascular disease (ASCVD). Atherosclerosis develops through the progressive deposition and retention of LDL C and other apoB containing lipoproteins within the arterial wall…

…prothrombotic state Albuminuria and declining estimated glomerular filtration rate Development of type 2 diabetes mellitus Atherosclerotic cardiovascular events HF and atrial fibrillation Obesity therefore acts…

…attempted recanalization of a chronic total coronary occlusion. Angina or ischaemia with non obstructive coronary arteries (ANOCA/INOCA), after appropriate investigation has identified the relevant…

…coronary arteries. It frequently coexists with left main coronary artery disease, diabetes mellitus, left ventricular dysfunction, peripheral vascular disease and other manifestations of diffuse atherosclerosis…

…coronary artery disease (LMCAD) refers to atherosclerotic narrowing of the left main coronary artery, which supplies the left anterior descending and left circumflex coronary territories…

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

…atherosclerotic arteries. This engenders the typical ECG changes as well. In acute coronary syndromes, however, symptoms and ECG changes are manifest at rest because of…

…atherosclerotic plaques start building up early in childhood and by middle age, most persons have some degree of atherosclerosis in the coronary arteries. Advanced atherosclerotic…

…reserve is the ratio of stress myocardial blood flow to resting myocardial blood flow. It provides an integrated measure influenced by epicardial stenosis, diffuse atherosclerosis…

…artery atherosclerosis and small vessel disease may also contribute to stroke in patients with AF. Stroke risk is heterogeneous and is determined principally by the…

…or obstruction of epicardial coronary arteries. Endothelial dysfunction, coronary microvascular disease and vasospasm may coexist with atherosclerosis or may be the dominant cause of ischaemia…

…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…

…including Takayasu arteritis and giant cell arteritis Bicuspid aortic valve Coarctation of the aorta Previous aortic trauma Pregnancy, particularly the third trimester Weightlifting Cocaine use…

…accelerates atherosclerosis, increases myocardial oxygen demand, and may worsen ischemia in patients with obstructive coronary disease. It is also the most prevalent antecedent of heart…

…erythematosus and antiphospholipid syndrome SLE may affect the cardiovascular system through several pathways, including: Coronary arteritis Accelerated atherosclerosis Coronary microvascular dysfunction Pericarditis Myocarditis Valvular disease…

…be beneficial, whereas triglyceride levels seem to be of little or no importance for atherosclerosis. When discussing atherosclerosis, the focus is on LDL cholesterol. Virtually…

… concealed diffuse atherosclerosis; myocardial bridging; myocardial metabolic abnormalities; and abnormal pain perception in patients without demonstrable ischaemia. The absence of obstructive disease therefore does not…

…appearance Diagnostic considerations Type 1 Contrast staining of the arterial wall with multiple lumens or radiolucent channels The classic appearance and usually readily recognized Type…

…and sudden cardiac death. The relationship between glycaemia and cardiovascular disease is complex. Glycaemic control is important for prevention of microvascular complications, but intensive glucose…

…calcification overlap with risk factors for coronary heart disease (atherosclerosis). The average age at diagnosis of aortic stenosis is 75 years in high income countries…

…have more atherosclerosis (both in frequency and severity) which may compensate for the inability to reach their maximal heart rate. Ultimately, the specificity of exercise…

…stabbing. Its location and radiation may reflect the segment of aorta involved, although the source material does not provide a detailed symptom to anatomy correlation…

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

…commonly reflects atherothrombosis: disruption of an atherosclerotic plaque followed by platelet activation and coagulation, with formation of an intraluminal thrombus. The clinical spectrum includes unstable…

…during the infection. Systemic inflammation results in increased levels of circulating pro inflammatory cytokines that may cause plaque rupture (i.e the risk of atherosclerotic…

…dedicated testing, or a qualitative assessment of CAC on a non gated chest CT, can modify the estimated likelihood of atherosclerotic obstructive CAD. CAC is…

…atherothrombosis. It is usually precipitated by disruption of an atherosclerotic plaque through rupture or erosion. The relative contributions of plaque disease and thrombus vary considerably…

…artery bypass grafting (CABG). Clinical Presentation and Symptoms The diagnosis of an acute MI remains a comprehensive clinical diagnosis based on patient symptoms, ECG changes…

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

…but an atherosclerotic plaque may prevent oxygen supply from increasing in parallel with oxygen demands. Depending on several factors– including the severity of the stenosis…

…known atherosclerotic disease. An ABI ≤ 0.90 is diagnostic of peripheral arterial disease and at the same time indicates a substantially increased risk of myocardial…

…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…

…the plaque exposes highly thrombogenic materials which activate circulating platelets and coagulation factors, which results in thrombus formation (Figure 1). Disruption of an atherosclerotic plaque…

…stronger predictor of death than the atherosclerotic burden. Assessment of the size, mass, geometry, and function of the left ventricle is fundamental for the diagnosis…

…be initiated concurrently. In patients with a confirmed indication for treatment but blood pressure in the range of 120–139/70–89 mmHg, concomitant indications…

…remnant lipoproteins and insulin resistance are associated with atherosclerotic cardiovascular disease (ASCVD), particularly in peripheral arterial disease. The relationship between triglyceride concentrations and aortic disease…

…with temporary mechanical circulatory support (MCS) considered as a bridge. Clinical Presentation and Symptoms Symptoms of STEMI The usual symptom is severe, prolonged ischemic discomfort…

…atherothrombotic events in chronic coronary disease; preserve the benefit of coronary intervention while limiting major and clinically relevant bleeding. Long term antiplatelet therapy after STEMI…

…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…

…consequent excess risk of premature atherosclerotic cardiovascular disease (ASCVD), particularly coronary artery disease (CAD). FH results from pathogenic variants affecting proteins in the hepatic LDL…

…the abdominal aortic diameter exceeds 3 cm. Most AAAs are located below the renal arteries and are related to atherosclerotic disease. At least 90% of…

…arteries is a major pathological substrate, but ischaemia may also result from epicardial vasomotor abnormalities or structural and functional microvascular disease. Thus, the presence of…

…atherosclerotic cardiovascular disease (ASCVD) or heterozygous familial hypercholesterolaemia. The broader therapeutic principle is that LDL C reduction is associated with cardiovascular benefit regardless of the…

…atherosclerotic disease, the international guideline identifies benefit from adding PCSK9 inhibition to statin therapy when LDL C is ≥1.8 mmol/L. In peripheral arterial…