What is the most common cause of coronary heart disease
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The Most Common Cause of Coronary Heart Disease
Atherosclerosis and Coronary Artery Disease
Plaque Build-Up in Coronary Arteries
The most common cause of coronary artery disease (CAD) is the build-up of plaque within the coronary arteries. This plaque consists of fatty deposits, cholesterol, cellular waste products, calcium, and other substances that accumulate on the inner walls of the arteries. Over time, this build-up narrows the arteries and restricts blood flow to the heart, which can lead to chest pain (angina), heart attacks, strokes, or heart failure .
Inflammation and Immune Response
Atherosclerosis, the primary cause of CAD, is an inflammatory disease. Immune mechanisms interact with metabolic risk factors to initiate, propagate, and activate lesions in the arterial tree. Immune cells dominate early atherosclerotic lesions, and their effector molecules accelerate the progression of these lesions. Activation of inflammation can elicit acute coronary syndromes, making inflammation a critical component in the development and exacerbation of CAD .
Plaque Disruption and Thrombosis
Plaque disruption with superimposed thrombosis is a significant cause of acute coronary syndromes, including unstable angina, myocardial infarction, and sudden death. The composition and vulnerability of the plaque, rather than its volume, are crucial determinants for the development of thrombus-mediated acute coronary syndromes. Lipid-rich and soft plaques are more prone to rupture and are highly thrombogenic after disruption, leading to life-threatening conditions.
Genetic Factors in Coronary Artery Disease
Heritability and Genetic Variants
Coronary artery disease is partly heritable, with numerous genetic loci linked to coronary risk. Advances in genetic research have facilitated a better understanding of the causal risk factors and underlying biology of CAD. Genetic testing holds promise for precision medicine approaches, potentially identifying subgroups of patients at increased risk or those with specific pathophysiologies that could benefit from targeted therapeutic or preventive measures .
Conclusion
In summary, the most common cause of coronary artery disease is the build-up of plaque within the coronary arteries, a process driven by a combination of metabolic risk factors and inflammatory responses. Plaque disruption and subsequent thrombosis are critical events leading to acute coronary syndromes. Additionally, genetic factors play a significant role in the susceptibility to CAD, offering potential pathways for personalized medical interventions. Understanding these mechanisms is essential for developing effective prevention and treatment strategies for coronary artery disease.
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