The Unstable Atherosclerotic Plaque: Clinical Significance and Therapeutic Intervention

• References

• 1 Fuster V, Badimon L, Badimon JJ, Chesebro JH. The pathogenesis of coronary artery disease and the acute coronary syndromes. N Engl J Med 1992; 326: 310-318
• 2 Ross R. The pathogenesis of atherosclerosis: A perspective for the 1990s. Nature 1993; 362: 801-809
• 3 Fuster V. Mechanisms leading to myocardial infarction: Insights from studies of vascular biology. Lewis A. Conner Memorial Lecture. Circulation 1994; 90: 2126-2146
• 4 Stary HC, Chandler AB, Dinsmore RE, Fuster V, Glagov S, Insull W, Rosenfeld ME, Schwartz CJ, Wagner WD, Wissler RW. A definition of advanced types of atherosclerotic lesions and a histological classification of atherosclerosis: A report from the Committee on Vascular Lesions of the Council on Arteriosclerosis American Heart Association. Circulation 1995; 92: 1355-1374
• 5 Fuster V. Human Lesion Studies. Ann NY Acad Science. 1997 (In Press)
• 6 Steinberg D. Oxidative modification of LDL and atherogenesis. Lewis A. Conner Memorial Lecture. Circulation 1997; 95: 1062-1071
• 7 Ross R, Fuster V. The pathogenesis of atherosclerosis. 1996 In Arteriosclerosis and Coronary Artery Disease. Fuster V, Ross R, … Topol E. Eds Vol 01. 441-460 Lippincott-Raven Publishers; Philadelphia, PA:
• 8 Badimon L, Badimin JJ, Fuster V. Regression of atherosclerotic lesions by high density lipoprotein plasma fractions in the cholesterol-fed rabbit. J Clin Invest 1990; 85: 1234-1241
• 9 Moncada S, Gryglewski R, Bunting S, Vane JR. An enzyme isolated from arteries transforms prostaglandin endoperoxides to an unstable substance that inhibits platelet aggregation. Nature 1976; 263: 663-665
• 10 Furchgott RF, Zawadzki JV. The obligatory role of endothelial cells in the relaxation of arterial smooth muscle by acetylcholine. Nature 1980; 288: 373-376
• 11 Yanagisawa M, Kurihara H, Chimaera S. et al: A novel potent vasoconstrictor peptide produced by vascular endothelial cells. Nature 1988; 332: 411-415
• 12 Selwyn AP, Kinlay S, Libby P, Ganz P. Atherogenic lipids, vascular dyrnunction, and clinical signs of ischemic heart disease. Circulation 1997; 95: 05-07
• 13 Reddy KG, Nair RN, Sheehan HM, Hodgson JM. Evidence that selective endothelial dysfunction may occur in the absence of angiographic or ultrasound atherosclerosis in patients with risk factors for atherosclerosis. J Am Coll Cardiol 1994; 25: 833-843
• 14 Richardson PD, Davies MJ, Born GV. Influence of plaque configuration and stress distribution on fissuring of coronary atherosclerotic plaques. Lancet 1989; 02: 1462-1463
• 15 Falk E, Shah PK, Fuster V. Coronary plaque disruption. Circulation 1995; 92: 657-671
• 16 Ambrose JA, Tannenbaum M, Alexpoulos D. et al: Angiographic progression of coronary artery disease and the development of myocardial infarction. J Am Coll Cardiol 1988; 12: 56-62
• 17 Little WC, Constantinescu M, Applegate RJ. et al: Can coronary angiography predict the site of a subsequent myocardial infarction in patients with mild-to-moderate coronary artery disease. Circulation 188; 78: 1157-1166
• 18 Davies MJ. Stability and instability: Two faces of coronary atherosclerosis. Circulation 1994; 2013-2019
• 19 Maclssac AL, Thomas JD, Topol EJ. Toward the quiescent coronary plaque. J Am Coll Cardiol 1993; 22: 1228-1241
• 20 Moreno PR, Falk E, Palacios IF, Newell JB, Fuster V, Fallon JT. Macrophage infiltration in acute coronary syndromes. Implications for plaque rupture. Circulation 1994; 90: 775-778
• 21 Shah PK, Falk E, Badimon JJ, Femandez-Ortiz A, Mailhac A, Villareal-Levy G, Fallon JT, Regnstrom J, Fuster V. Human monocyte-derived macrophages induce collagen breakdown in fibrous caps of atherosclerotic plaques. Potential role of matrix-degrading metalloproteinases and implications for plaque rupture. Circulation 1995; 92: 1565-1569
• 22 Galis ZS, Sukhova GK, Lark MW, Libby P. Increased expression of matrix metalloproteinase and matrix degrading activity in vulnerable regions of human atherosclerotic plaques. J Clin Invest 1994; 94: 2493-2503
• 23 Galis ZS, Sukhova GK, Kranzhofer R, Clark S, Libby P. Macrophage foam cells from experimental atheroma constituitively produce matrix-degrding proteinases. Proc Nad Acad Sci USA 1995; 92: 402-406
• 24 Fuster V, Fallon JT, Nemerson Y. Coronary thrombosis. The Lancet 1996; 348 (Suppl) s7-s10
• 25 Dobroski DR, Loscalzo J. Thrombotic risk factors for atherosclerosis. Cor ArtDis 1995; 07: 919-932
• 26 Femandez-Ortiz A, Badimon JJ, Falk E, Fuster V, Meyer B, Mailhac A, Weng D, Shah PK, Badimon LL. Characterization of the relative thrombogenicity of atherosclerotic plaque components: Implications for consequences of plaque rupture. J Am Coll Cardiol 1994; 23: 1562-1569
• 27 Banner DW, D’Arcy A, Chene C, Winkler FK, Guha A, Konigsberg WH, Nemerson Y, Kirchlofer D. The crystal structure of the complex of blood coagulation factor Vila with soluble tissue factor. Nature 1996; 380: 41-46
• 28 Thiruvikraman SV, Guha A, Roboz J, Taubman MB, Nemerson Y, Fallon JT. In situ localization of tissue factor in human atherosclerotic plaques by binding of digoxigenin labeled factors VIIa and X. Lab. Inv 1996; 75: 451-461
• 29 Toschi V, Gallo R, Lettino M, Fallon JT, Femandez-Ortiz A, Badimon L, Chesebro JH, Nemerson Y, Fuster V, Badimon JJ. Tissue factor predicts the thrombogenicity of human atherosclerotic plaque components. Circulation 1997; 95: 594-599
• 30 Moreno PR, Bernardi VH, Lopez-Cuellar J, Murcia AM, Palacios IF, Gold HK, Mehran R, Sharma SK, Nemerson Y, Fuster V, Fallon JT. Macrophages, smooth muscle cells and tissue factor in unstable angina: Implications for cell mediated thrombogenicity in acute coronary syndromes. Circulation 1996; 94: 3090-3097
• 31 Marmur JDE, Thiruvikraman SV, Fyfe BS, Guha A, Sharma SH, Ambrose JH, Fallon JT, Nemerson Y, Taubman M. The identification of active tissue factor in human coronary atheroma. Circulation 1996; 94: 1226-1232
• 32 Fuster V, Badimon JJ. Regression or stabilization of atherosclerosis means regression or stabilization of what we don’t see in the arteriogram. Eur Heart J 1995; 16: 06-12
• 33 Blankenhorn DH, Hodis HN. George Lyman Duff Memorial Lecture. Arterial imaging and atherosclerotic reversal. Arterioscler Thromb 1994; 14: 177-192
• 34 Scandinavian Simvastatin Survival Study Group. Randomised trial of cholesterol lowering in 4,444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet 1994; 344: 1383-1389
• 35 The Cholesterol And Recurrent Events (CARE) Trial Investigators. The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. N Engl J Med 1996; 335: 1001-1009
• 36 Shepard J, Cobbe SM, Ford I. et al: Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. N Engl J Med 1995; 333: 1301-1307
• 37 Brown BG, Zhao XO, Sacco DE, Albers JJ. Lipid lowering and plaque regression. New insights into prevention of plaque disruption and clinical events in coronary disease. Circulation 1993; 87: 1781-1791
• 38 Small DM. Progression and regression of atherosclerotic lesions. Insights from Lipid- Physical Biochemistry. Arteriosclerosis 1988; 08: 103-129
• 39 Loree HM, Tobias BJ, Gibson LJ, Kamm RD, Small DM, Lee RT. Mechanical properties of model atherosclerotic lesion lipid pool. Athero Thromb 1994; 14: 230-234
• 40 Guyton JR, Klemp KF. Development of the atherosclerotic core region. Chemical and ultrastructure analysis of microdissected atherosclerotic lesions from human aorta. Arterioscler Thromb 1994; 14: 1305-1314
• 41 Toussaint J-F, Southern JF, Fuster V, Kantor HL. 13C-NMR spectroscopy of human atherosclerotic lesions: Relation between fatty acid saturation, cholesteryl ester contents, and luminal obstruction. Arterioscler Thromb 1994; 14: 1951-1957
• 42 Coumadin Aspirin Reinfarction Study (CARS) Investigators. A randomized, double-blind study of fixed low-dose warfarin plus aspirin in post-myocardial infarction patients. The Lancet. (Submitted)
• 43 Stroke Prevention in Atrial Fibrillation Investigators. Adjusted- dose warfarin versus low- intensity, fixed-dose warfarin plus aspirin for high-risk patients with atrial fibrillation: Stroke Prevention in Atrial Fibrillation III randomised clinical trial. Lancet 1996; 348: 633-638
• 44 The Post Coronary Artery Bypass Graft Trial Investigators. The effect of aggressive lowering of low-density lipoprotein cholesterol levels and low-dose anticoagulation on obstructive changes in saphenous-vein coronary artery bypass grafts. N Engl J Med 1997; 336: 152-162
• 45 Badimon JJ, Lettino M, Toschi V, Gallo R, Fallon JT, Nemerson Y, Badimon L, Chesebro JH, Fuster V. Inhibitory effects of TFPA on thrombus formation triggered by lipid-rich human atherosclerotic plaques. Circulation 1995; 92 (Suppl I) 001-693