Pathophysiology and clinical significance of atherosclerotic plaque rupture

David E. Gutstein, Valentin Fuster

Research output: Contribution to journalReview articlepeer-review

122 Scopus citations


Atherosclerotic plaque rupture and resulting intracoronary thrombosis are thought to account for most acute coronary syndromes. These syndromes include unstable angina, non-Q-wave myocardial infarction (MI) and Q-wave MI. In addition, many cases of sudden cardiac death may be attributable to atherosclerotic plaque disruption and its immediate complications. Our understanding of the atherosclerotic process and the pathophysiology of plaque disruption has advanced remarkably. Despite these advances, event rates after acute coronary syndromes remain unacceptably high. This review will focus on the pathophysiology underlying atherosclerotic plaque development, the sequellae of coronary plaque rupture, and current therapies designed to treat the acute coronary syndromes. It is hoped that as our understanding of the atherosclerotic plaque improves, treatment strategies for the acute coronary syndromes will advance.

Original languageEnglish
Pages (from-to)323-333
Number of pages11
JournalCardiovascular Research
Issue number2
StatePublished - 1 Feb 1999


  • Atherosclerosis
  • Coronary disease
  • Infarction
  • Ischemia
  • Thrombosis


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