Summary: The Two Extremes Of Coronary Artery Disease

This figure shows the 2 different extremes of coronary artery disease plaques that can build up in the arteries. Stenotic lesions have more compact lipid cores, with more fibrosis and calcification with thick fibrous caps. There is less enlargement due to positive remodeling in these plaques. These types produce ischemia which is treated by medical therapy and revascularization surgery for relief of symptoms. Nonstenoic lesions are the more dominant type in the body and are more common than stenoic plaques. With much larger lipid cores and thinner fibrous capsules, these plaques are more likely to rupture and cause thrombosis. There is usually much more “compensatory enlargement” in these types also which can make determining the size of them …show more content…
These drugs influence the heart rate as well as the inotropic and loading conditions of the heart. Drugs that increase the efficiency of energy production are also starting to be considered, these drugs inhibit free fatty acid oxidation and increase glucose utilization. There are revasculization procedures that can restore blood flow in the coronary artery in most patients. These consist stimulation of arteriogenesis by gene, protein, or cell therapy (Libby & Theroux, …show more content…
Statins are structurally similar to HMG, which is a substrate of HMG-CoA reductase. Through reversible inhibition of HMG-CoA reductase, intracellular cholesterol is decreased which then results in an increased number of LDL-receptors on the cell surface. The extra receptors than result in increased catabolism and clearance of circulating LDL cholesterol. Some statins also work by inhibiting LDL production via the inhibition of synthesis of hepatic VLDL (the precursor to circulating LDL) (Goodman et. al,