Worldwide, cardiovascular incidents are estimated to cause 17.5 million deaths, 80% of which are ischemic strokes or acute coronary syndromes. Cardiovascular disease results in a significant financial burden for healthcare system—namely, in 2009, it was 9% of the gross health service expenditure in the European Union. Therefore, the development of the knowledge about atherosclerosis—initially thought to be solely degenerative disorder but now considered a multifactorial inflammatory state—is essential. Acute coronary syndrome (ACS) is usually a manifestation of severe reduction in coronary blood flow caused by atherosclerotic plaque and thrombus. The pathology of the atherosclerotic plaque is complex. Essentially, it is disease of the arterial intima that, through subsequent stages, results to luminal narrowing. Over the years, various theories regarding the genesis growth and vulnerability of atherosclerotic lesions have been promoted, usually focusing on endothelial injury, smooth muscle cell proliferation, lipid accumulation, and, more recently, inflammatory reactions.
Part of the book: Atherosclerosis