33 Coronary Artery Disease Flashcards
atherosclerosis is characterized by…
lipid deposits w/in the intima of the artery
____ + ____ play a key role in the dvlpt of atherosclerosis
endothelial injury + inflammation
C-Reactive Protein [CRP]
protein made by liver
-nonspecific marker of inflammation
markers of inflammation in CAD
c-reactive protein + lipoprotein
usually, when pt becomes symptomatic…
the disease process usually is well advanced
stages of CAD
1 fatty streak
2 fibrous plaque
3 complicated lesions
complicated lesions
fibrous plaque grows> contd inflammatn can result in plaque instability , ulceration, + rupture> plaque rupture> platelet accumulation> thrombus>
collateral circulation
arterial anastomoses or connections
2 factors that contribute to formation of collateral circulation
1 inherited predisposition to dvlp new blood vessels [angiogenesis]
2 presence of chronic ischemia [poor blood flow]
CAD modifiable risk factors
- serum lipids
- HTN
- diabetes
- tobacco
- phys inactivity
- obesity
serum lipids as risk factors
CHOLSTRL>200
TRGLCRD>150
LDL>130
HDL<40 in men <50 in women
obesity as risk factors
waist circumference
>102cm/40in in men
>88cm/35in in women
collateral circulation provides adequate blood + O2 except…
during increased workload like exercise
nicotine
causes catecholamine (epinephrn, norepinephrn) >causes incr HR, BP, and peripheral vasoconstriction
tobacco smoke
cause incr LDL, decr HDL, release of toxic O2 radicals
homocysteine
made by breakdown of essential amino acid methionine found in dietary protein
- causes damage to inner lining of bld vssls
- promtes plaque buildup
- incr clotting
fat intake should be…
25-35% of total cals
-w most coming fr monosat + polysat fats
statin drugs
- inhibit the synth of cholesterol in liver
- incr hepatic LDL receptor
- —-allows for liver to remove more LDL
- minor incr in HDL
- lower CPR levels
most potent statin
rosuvastatin
fibric acid derivative (drug + moa)
gemfibrozil
- removes VLDL
- lowers trglcrd
- incr HDL
- *no effect on LDL**
