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Atherosclerotic Coronary Disease

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Principles of Molecular Medicine

Abstract

Atherosclerotic coronary artery disease is a complex biological process resulting in narrowing of the arterial vessels that supply the heart muscle with oxygen and nutrients. Despite major advances in the understanding of this process and its clinical management, it remains a major cause of morbidity and mortality throughout the world. In the United States, coronary artery disease accounts for about 500,000 deaths each year, of which about half are sudden. This chapter reviews the clinical presentation and treatment of this condition, focusing on advances and the biological insights they provide. Some of the leading hypotheses regarding the molecular mechanisms underlying this incompletely understood condition are considered.

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Selected References

  • Andersen HR, Nielsen TT, Rasmussen K, et al. A comparison of coronary angioplasty with fibrinolytic therapy in acute myocardial infarction. N Engl J Med 2003;349:733–742.

    Article  PubMed  Google Scholar 

  • Boring L, Gosling J, Cleary M, Charo I. Decreased lesion formation in CCR2-/-mice reveals a role for chemokines in the initiation of atherosclerosis. Nature 1998;394:894–897.

    Article  PubMed  CAS  Google Scholar 

  • Braunwald E, Zipes DP, Libby P, (eds.) Heart Disease: A Textbook of Cardiovascular Medicine. 6th ed. Philadelphia: W. B. Saunders Company, 2001.

    Google Scholar 

  • Breslow JL. Mouse models of atherosclerosis. Science 1996;272:685–688.

    Article  PubMed  CAS  Google Scholar 

  • Collins T, Cybulsky MI. NF-kappaB: Pivotal mediator or innocent bystander in atherogenesis? J Clin Invest 2001;107:255–264.

    PubMed  CAS  Google Scholar 

  • Colombo A, Orlic D, Stankovic G, et al. Preliminary observations regarding angiographic pattern of restenosis after rapamycin-eluting stent implantation. Circulation 2003;107:2178–2180.

    Article  PubMed  Google Scholar 

  • Cybulsky MI, Gimbrone MA Jr. Endothelial expression of a mononuclear leukocyte adhesion molecule during atherogenesis. Science 1991;251:788–791.

    Article  PubMed  CAS  Google Scholar 

  • Davies MJ, Richardson PD, Woolf N, Katz DR, Mann J. Risk of thrombosis in human atherosclerotic plaques: Role of extracellular lipid, macrophage, and smooth muscle cell content. Br Heart J 1993;69:377–381.

    Article  PubMed  CAS  Google Scholar 

  • Fazio S, Linton MF. Mouse models of hyperlipidemia and atherosclerosis. Front Biosci 2001;6:D515–525.

    Article  PubMed  CAS  Google Scholar 

  • Fuster V, Lewis A. Conner Memorial Lecture. Mechanisms leading to myocardial infarction: insights from studies of vascular biology. Circulation 1994;90:2126–2146.

    PubMed  CAS  Google Scholar 

  • Gerszten RE, Garcia-Zepeda EA, Lim YC, et al. MCP-1 and IL-8 trigger firm adhesion of monocytes to vascular endothelium under flow conditions. Nature 1999;398:718–723.

    Article  PubMed  CAS  Google Scholar 

  • Gu L, Okada Y, Clinton SK, et al. Absence of monocyte chemoattractant protein-1 reduces atherosclerosis in low density lipoprotein receptordeficient mice. Mol Cell 1998;2:275–281.

    Article  PubMed  CAS  Google Scholar 

  • Hajra L, Evans AI, Chen M, Hyduk SJ, Collins T, Cybulsky MI. The NF-kappa B signal transduction pathway in aortic endothelial cells is primed for activation in regions predisposed to atherosclerotic lesion formation. Proc Natl Acad Sci USA 2000;97:9052–9057.

    Article  PubMed  CAS  Google Scholar 

  • Haley KJ, Lilly CM, Yang JH, et al. Overexpression of eotaxin and the CCR3 receptor in human atherosclerosis: Using genomic technology to identify a potential novel pathway of vascular inflammation. Circulation 2000;102:2185–2189.

    PubMed  CAS  Google Scholar 

  • Heeschen C, Dimmeler S, Hamm CW, et al. Soluble CD40 ligand in acute coronary syndromes. N Engl J Med 2003;348:1104–1111.

    Article  PubMed  CAS  Google Scholar 

  • Hill JM, Zalos G, Halcox JP, et al. Circulating endothelial progenitor cells, vascular function, and cardiovascular risk. N Engl J Med 2003;348:593–600.

    Article  PubMed  Google Scholar 

  • Hirschhorn JN, Lohmueller K, Byrne E, Hirschhorn K. A comprehensive review of genetic association studies. Genet Med 2002;4:45–61.

    Article  PubMed  CAS  Google Scholar 

  • Iiyama K, Hajra L, Iiyama M, et al. Patterns of vascular cell adhesion molecule-1 and intercellular adhesion molecule-1 expression in rabbit and mouse atherosclerotic lesions and at sites predisposed to lesion formation. Circ Res 1999;85:199–207.

    PubMed  CAS  Google Scholar 

  • Kuhlencordt PJ, Gyurko R, Han F, et al. Accelerated atherosclerosis, aortic aneurysm formation, and ischemic heart disease in apolipoprotein E/endothelial nitric oxide synthase double-knockout mice. Circulation 2001;104:448–454.

    Article  PubMed  CAS  Google Scholar 

  • Lander E, Kruglyak L. Genetic dissection of complex traits: guidelines for interpreting and reporting linkage results. Nat Genet 1995;11:241–247.

    Article  PubMed  CAS  Google Scholar 

  • Lindahl B, Toss H, Siegbahn A, Venge P, Wallentin L. Markers of myocardial damage and inflammation in relation to long-term mortality in unstable coronary artery disease. FRISC Study Group. Fragmin during Instability in Coronary Artery Disease. N Engl J Med 2000;343:1139–1147.

    Article  PubMed  CAS  Google Scholar 

  • Linton MF, Farese RV Jr, Chiesa G, et al. Transgenic mice expressing high plasma concentrations of human apolipoprotein B100 and lipopro-tein(a). J Clin Invest 1993;92:3029–3037.

    Article  PubMed  CAS  Google Scholar 

  • Lohmueller KE, Pearce CL, Pike M, Lander ES, Hirschhorn JN. Metaanalysis of genetic association studies supports a contribution of common variants to susceptibility to common disease. Nat Genet 2003;33:177–182.

    Article  PubMed  CAS  Google Scholar 

  • Nakashima Y, Plump AS, Raines EW, Breslow JL, Ross R. ApoE-deficient mice develop lesions of all phases of atherosclerosis throughout the arterial tree. Arterioscler Thromb 1994;14:133–140.

    PubMed  CAS  Google Scholar 

  • Park SJ, Shim WH, Ho DS, et al. A paclitaxel-eluting stent for the prevention of coronary restenosis. N Engl J Med 2003;348:1537–1545.

    Article  PubMed  CAS  Google Scholar 

  • Plump AS, Smith JD, Hayek T, et al. Severe hypercholesterolemia and atherosclerosis in apolipoprotein E-deficient mice created by homologous recombination in ES cells. Cell 1992;71:343–353.

    Article  PubMed  CAS  Google Scholar 

  • Quaini F, Urbanek K, Beltrami AP, et al. Chimerism of the transplanted heart. N Engl J Med 2002;346:5–15.

    Article  PubMed  Google Scholar 

  • Ridker PM, Rifai N, Rose L, Buring JE, Cook NR. Comparison of C-reac-tive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events. N Engl J Med 2002;347:1557–1565.

    Article  PubMed  CAS  Google Scholar 

  • Ritchie ME. Nuclear factor-kappaB is selectively and markedly activated in humans with unstable angina pectoris. Circulation 1998;98:1707–1713.

    PubMed  CAS  Google Scholar 

  • Rosenzweig A. Endothelial progenitor cells. N Engl J Med 2003;348:581, 582.

    Article  PubMed  Google Scholar 

  • Ross R. Atherosclerosis-an inflammatory disease. N Engl J Med 1999;340:115–126.

    Article  PubMed  CAS  Google Scholar 

  • Scandinavian Simvastatin Study Group. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: The Scandinavian Simvastatin Survival Study (4S). Lancet 1994;344:1383–1389.

    Google Scholar 

  • Serruys PW, Degertekin M, Tanabe K, et al. Intravascular ultrasound findings in the multicenter, randomized, double-blind RAVEL (Randomized study with the sirolimus-eluting Velocity balloon-expandable stent in the treatment of patients with de novo native coronary artery Lesions) trial. Circulation 2002;106:798–803.

    Article  PubMed  CAS  Google Scholar 

  • Shi W, Haberland ME, Jien ML, Shih DM, Lusis AJ. Endothelial responses to oxidized lipoproteins determine genetic susceptibility to atherosclerosis in mice. Circulation 2000;102:75–81.

    PubMed  CAS  Google Scholar 

  • Smith JD, Trogan E, Ginsberg M, Grigaux C, Tian J, Miyata M. Decreased atherosclerosis in mice deficient in both macrophage colony-stimulating factor (op) and apolipoprotein E. Proc Natl Acad Sci USA 1995;92:8264–8268.

    Article  PubMed  CAS  Google Scholar 

  • Vasa M, Fichtlscherer S, Adler K, et al. Increase in circulating endothelial progenitor cells by statin therapy in patients with stable coronary artery disease. Circulation 2001;103:2885–2890.

    Article  PubMed  CAS  Google Scholar 

  • Zhang SH, Reddick RL, Piedrahita JA, Maeda N. Spontaneous hypercholesterolemia and arterial lesions in mice lacking apolipoprotein E. Science 1992;258:468–471.

    Article  PubMed  CAS  Google Scholar 

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© 2006 Humana Press Inc.

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Gerszten, R.E., Rosenzweig, A. (2006). Atherosclerotic Coronary Disease. In: Runge, M.S., Patterson, C. (eds) Principles of Molecular Medicine. Humana Press. https://doi.org/10.1007/978-1-59259-963-9_14

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  • DOI: https://doi.org/10.1007/978-1-59259-963-9_14

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-202-5

  • Online ISBN: 978-1-59259-963-9

  • eBook Packages: MedicineMedicine (R0)

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