Atherosclerosis Flashcards
Risk factors for atherosclerosis
Age, smoking (damages endothelial cells), high serum cholesterol, obesity, diabetes, hypertension, family history, diabetes, excess alcohol, lack of exercise, males>females
Haemodynamic factors affecting plaque distribution
Changes in flow/turbulence of blood at bifurcations
A plaque occluding the lumen of vessels can cause
Restriction of blood flow (angina)
Rupture (thrombus formation - death)
Good outcomes of inflammation
Pathogens, parasites, wound healing
Bad outcomes of inflammation
Myocardial reperfusion injury, atherosclerosis, ischaemic heart disease, rheumatoid arthritis, asthma, IBD, shock, excessive wound healing
What ignites inflammation in artery walls?
LDL
Endothelial dysfunction
Name the inflammatory cytokines
IL-1, IL-6, IL-8, IFN-g, TGF-b, MCP-1
What is the earliest stage in atherosclerosis progression?
Fatty streak
What does an intermediate lesion consist of?
Lipid laden macrophages, vascular smooth muscle cells, T lymphocytes, adhesion and aggregation of platelets to vessel wall, isolated pools of extracellular lipid
What are the stages of progression of atherosclerosis?
Fatty streaks > intermediate lesions > fibrous plaques or advanced lesions > plaque rupture (causes thrombus formation and vessel occlusion) > plaque erosion
What interventions can be used for atherosclerosis?
PCI - percutaneous coronary intervention, stent implantation
Drug elution - taxol, sirolimus
Name 3 ways to prevent atherosclerosis
Statins for primary prevention of CHD - reduce cholesterol levels
Smoking cessation
Alcohol and exercise
