title: [Progression of coronary disease: minutes, weeks, decades...].
abstract: The slow progression over decades of coronary atheroma is often compensated for by arterial remodeling and collateral circulation. Coronary artery disease is therefore often asymptomatic. Sudden rupture of unstable atheromatous plaque always leads to endocoronary thrombus formation. The magnitude and the time frame of this endovascular thrombotic process determine the severity of its clinical consequences: no symptoms, exercise angina, unstable angina, acute transmural myocardial infarction, or sudden death. Two amply validated treatments have the potential to decrease both the probability and the severity of plaque rupture: statins and platelet inhibitors, which are both indicated in all cases of coronary disease. The other therapeutic tools - anti-ischemic drugs, ACE inhibitors, angioplasty, and coronary bypass - are widely used in the management of coronary disease, but their indications should be tailored to each individual clinical situation.
authors.affiliation: Hôpital Cochin, AP-HP, 27, rue Faubourg St Jacques, 75014 Paris, France. simon.weber@cch.aphp.fr
authors.forename: S
authors.initials: S
authors.lastname: Weber
mesh_terms: D002317:Cardiovascular Agents / Q000627:therapeutic use; D003327:Coronary Disease / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D003328:Coronary Thrombosis / Q000503:physiopathology; D018450:Disease Progression; D006801:Humans; D007249:Inflammation / Q000503:physiopathology; D009204:Myocardial Revascularization; D012307:Risk Factors; D012421:Rupture
chemical_list: D002317:Cardiovascular Agents