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The new paradigm for coronary artery disease: altering risk factors, atherosclerotic plaques, and clinical prognosis.

Authors
  • O'Keefe, J H Jr
  • Conn, R D
  • Lavie, C J
  • Bateman, T M
Type
Published Article
Journal
Mayo Clinic proceedings
Publication Date
Oct 01, 1996
Volume
71
Issue
10
Pages
957–965
Identifiers
PMID: 8820770
Source
Medline
License
Unknown

Abstract

The old paradigm states that the greater the stenosis, the greater the risk of cardiac events. Revascularization procedures are the only effective approach to improving prognosis associated with coronary artery disease. In contrast, on the basis of the new paradigm, the nature of the plaque determines the risk of acute cardiovascular events. Dangerous plaques have a lipid-rich core with surrounding inflammation and a thin friable overlying fibrous cap, but they usually appear innocuous on angiography. Effective risk factor modification stabilizes the dangerous plaques and is associated with prompt improvement in endothelial dysfunction and a substantial decrease in the risk of acute cardiovascular events and death.

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