ROLE OF PLATELETS AND THROMBOSIS IN CORONARY ATHEROSCLEROTIC DISEASE AND SUDDEN-DEATH
ROLE OF PLATELETS AND THROMBOSIS IN CORONARY ATHEROSCLEROTIC DISEASE AND SUDDEN-DEATH
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DOI：
10.1016/s0735-1097(85)80552-0
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发表时间：
1985-01-01
影响因子：
24
通讯作者：
CHESEBRO, JH
中科院分区：
文献类型：
--
作者：
FUSTER, V;STEELE, PM;CHESEBRO, JH
在过去的十年中，对冠状动脉粥样硬化性疾病的发病机制的了解取得了重大进展。两个事实是重要的：1)早期和部分晚期冠状动脉粥样硬化病变进展非常缓慢，可能是一个复杂的循序渐进的生物过程，其中一个步骤是血小板与动脉壁之间的相互作用；这一过程可以被所谓的动脉粥样硬化疾病的危险因素所支持，2)一些晚期冠状动脉粥样硬化病变进展非常迅速，可能是通过复杂的解剖事件，其中之一与血栓形成过程有关。从临床的角度来看，技术的改进，如连续冠状动脉造影术，急性冠状动脉综合征期间的再灌注，死后冠状动脉造影术，以及一系列组织病理学和组织化学研究的方法，揭示了斑块破裂、夹层出血和最重要的血栓形成过程的临床重要性。这些复杂的过程在包括不稳定心绞痛、心肌梗死和冠脉猝死在内的一些急性冠脉综合征的发病机制中起着至关重要的作用。抗血栓和血小板抑制疗法正在研究中，在这些患者中的一些亚群中似乎很有希望。
During the last decade, significant advances have been made in the understanding of the pathogenesis of coronary atherosclerotic disease. Two facts are important: 1) the early and some of the advanced coronary atherosclerotic lesions progress very slowly, probably by means of a complex stepwise biologic process with one of the steps being an interaction between platelets and the arterial wall; the process can be favored by the so-called risk factors of atherosclerotic disease, and 2) some of the advanced coronary atherosclerotic lesions progress very rapidly, probably by means of complicating anatomic events, one of which is related to a thrombogenic process.From a clinical point of view, technologic improvements, such as serial coronary arteriography, reperfu- sion during the acute coronary artery syndromes, postmortem coronary arteriography, and methods for serial histopathologic and histochemical studies, have brought to light the clinical importance of the processes of plaque rupture, dissecting hemorrhage and, most important, thrombosis. These complicated processes appear to be of paramount importance in the pathogenesis of some of the acute coronary syndromes including unstable angina, myocardial infarction and sudden coronary death. Antithrombotic and platelet inhibitor therapy is under investigation and appears promising in some of these patient subsets.