M Batlouni — Page 4 | Search PubMed

Unstable coronary syndromes-unstable angina, acute myocardial infarction and sudden death-share a common pathophysiology, characterized by the rupture or fissure of an atherosclerotic plaque in the ischemic event related artery. This change marks the transitions from chronic, stable to acute, unstable coronary artery disease. The events that follow plaque rupture, namely platelet adhesion and aggregation, are largely responsible for endothelial injury and the interaction of the plaque components with the blood cells. Such phenoma are not isolated or self contained, but rather dynamic and inter-related. Advances in the knowledge of unstable acute syndromes had a major impact on the therapy of these conditions, particularly on the clinical approach. Besides alleviating and preventing the onset of symptoms reducing total ischemic burden, myocardial protection and preventing or improving left ventricular dysfunction, the new management of unstable coronary syndromes highlights the use of antithrombotic drugs and measures, pharmacological or not, aimed at the protection of the endothelium, stabilization of the plaque and control or even regression of atherosclerosis. Such an approach yields significant coronary event reduction, improved quality of life and increased survival.

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