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Atherosclerotic Artery Disease

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Atherosclerosis a chronic, inflammatory disease of the medium and large arteries, peripheral arteries, carotid and the aorta is a major contributor to the development of cardiovascular disease and the leading cause of death worldwide. Aherosclerotic plaque formation is a local process in the vessel wall with symptoms in the specific area, though the possibility of plaque formation at the same time and in different areas of the vasculature, regards the disease as systemic one1-3. Furthermore it is recognized that atherosclerotic carotid arteries pose a substantial risk of ipsilateral cerebrovascular events, with reported annual ischemic stroke rates ranging from .35% to 1.3% in asymptomatic patients with moderate stenosis4,5 and from .5% to …show more content…

These cells are able to produce and secrete such mediator molecules, like cytokines, chemokines, growth-factors, enzymes, and disintegrins, which activate endothelial cells, proliferation of smooth muscle cells, lesion progression, and the weakening of a vulnerable plaque by matrix degradation of its fibrous cap. Many of these molecules involved can be measured systemically and has been shown that elevated concentrations in the circulation are associated with future cardiovascular …show more content…

It is also suggested that inflammatory markers are transcribed locally in atherosclerotic plaques12-14. Other markers associated with carotid atherosclerotic plaques are: matrix metalloproteinases (MMPs)15, tissue inhibitor of metalloproteases(TIMP)16, soluble intercellular adhesion molecule 117 and osteopontin18,19 . MMPs are a family of zinc-containing enzymes and are secreted as inactive precursors. They are prevalent in the arterial wall throughout the arterial system. Metalloproteases play a central role in degradation of the vascular extracellular matrix resulting in destabilization of the atherosclerotic plaque15. The destabilization event contributes to plaque rupture and consequently in acute ischemic events. Increased carotid MMP-9 plaque levels are associated with an unstable plaque phenotype and are higher in lipid-rich inflammatory plaques. Osteopontin, an acidic phosphoprotein, has recently been demonstrated to inhibit mineral deposition as well as osteoclastogenesis and it is constitutively expressed by a wide range of cell types in the vasculature. Carotid plaque contains valuable information for follow up after vascular surgery. It has been shown that local plaque characteristics are associated with restenosis at the site of carotid

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