Pathophysiology of plaque rupture and the concept of plaque stabilization.

Atherosclerotic coronary artery disease is the major cause of death, in men and women, in the United States and in much of the Western world. Atherosclerosis is responsible for coronary heart disease, limb ischemia, and most strokes. Although luminal narrowing by an atherosclerotic plaque and exaggerated or anomalous vasoconstriction contribute to some of the clinical manifestations of atherosclerotic arterial disease, it is the superim-position of a thrombus over an underlying ruptured or eroded plaque that results in the acute coronary syndromes (unstable angina, acute myocardial infarction, and sudden death) that are the most serious clinical manifestations of this disease.