[Etiology, pathogenesis and clinical course of unstable coronary artery disease].
The clinical presentations of ischemic heart disease comprises the term of acute ischaemia syndromes, that include unstable angina pectoris, non-Q-wave myocardial infarction, Q-wave-myocardial infarction and sudden death. Among the different presentations of acute ischemic syndromes, tha unstable angina and non-Q-wave myocardial infarction can be regarded together. In both pathologic entity, the plaque rupture, or erosion signifies the primary event, which is the source of the highly thrombogenic substances coming out from the core of the atherosclerotic plaque and entering to the coronary and systemic circulation. They cause a thrombocyte-rich "white" intracoronary thrombus, that is not fully obstructive, or there is adequate collateral circulation, being the pathogenetic substrate that prevents the development of transmural necrosis. The nosologically-bound two clinical entity can be called as "unstable coronary artery disease" (UCAD), since they have uniform etiologic, risk stratification and therapeutic backgrounds and also therapeutic targets that are basically distinct, they are admitted for transmural "ST-elevation" infarction. The review is discussing the etiology, pathophysiology, the role of inflammation factors, the problems of diagnostics, as well as risk stratification of the disease in the light of the recent guidelines of the European Society of Cardiology and multicenter evidence based studies.
Préda
István
I
Semmelweis Egyetem, Altalános Orvostudományi Kar II. sz. Kardiológiai Tanszék, Budapest.
D000789:Angina, Unstable / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D003097:Collateral Circulation; D017023:Coronary Angiography; D003326:Coronary Circulation; D003328:Coronary Thrombosis / Q000209:etiology / Q000503:physiopathology; D004452:Echocardiography; D004562:Electrocardiography; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology
D015415:Biomarkers