Coronary Aerosclerosis
Definition Clinical Manifestations
abnormal accumulation of lipid deposits/Þbrous tissue in
arterial walls and lumen Ischemia
Angina Pectoris (most common)
relieved with rest
Paophysiology
injury to vascular endothelium
Sudden Cardiac Death
stops producing antithrombotic
and vasodilating agents asymptomatic (mainly in women)
Inßammation attracts macrophages -Indigestion, nausea, palpitations,
Macrophages engolf lipids numbness
Fat streak forms in arterial wall
LDL oxidation (worsens condition) Epigastric Distress
Atheroma forms causing ischemia
radiating pain to jaw or left
arm/shortness of breath
Modifiable Risk Factors
hyperlipidemia
C Reactive
hypertension
Protein (CRP)
diabetes
metabolic syndrome inßammatory marker for cardiovascular risk Fasting Lipid ProÞle
obesity Value
physical inactivity Males Females
LDL < 100 mg/dL (70 mg/dL high risk)
chronic inßammatory conditions > 50 mg/dL
HDL 40 mg/dL
i.e. rheumatoid arthritis, lupus, HIV/AIDS < 150 mg/dL
chronic kidney disease Triglyceride
Total cholesterol < 200 mg/dL
Nonmodifiable Risk Factors Medications Lipids
family history of CAD HMG-CoA (Statins)
older age Atorvastatin, lovastatin, pravastatin,
gender (men develop CAD earlier than women) rosuvastatin, simvastatin
race (greater incidence of heart disease in African-American) Nicotinic acid (Niacin/VitB)
history of premature menopause Fibric Acid (Fibrates)
history of pregnancy associated disorders FenoÞbrate, gemÞbrozil, fenoÞbric acid
i.e. preeclampsia Bile acids sequestrants
primary hypercholesteremia Cholestyramine, colestipol, colesevelam
Cholesterol absorption inhibitors
Ezetimibe
Omega acid ethyl ester
Definition Clinical Manifestations
abnormal accumulation of lipid deposits/Þbrous tissue in
arterial walls and lumen Ischemia
Angina Pectoris (most common)
relieved with rest
Paophysiology
injury to vascular endothelium
Sudden Cardiac Death
stops producing antithrombotic
and vasodilating agents asymptomatic (mainly in women)
Inßammation attracts macrophages -Indigestion, nausea, palpitations,
Macrophages engolf lipids numbness
Fat streak forms in arterial wall
LDL oxidation (worsens condition) Epigastric Distress
Atheroma forms causing ischemia
radiating pain to jaw or left
arm/shortness of breath
Modifiable Risk Factors
hyperlipidemia
C Reactive
hypertension
Protein (CRP)
diabetes
metabolic syndrome inßammatory marker for cardiovascular risk Fasting Lipid ProÞle
obesity Value
physical inactivity Males Females
LDL < 100 mg/dL (70 mg/dL high risk)
chronic inßammatory conditions > 50 mg/dL
HDL 40 mg/dL
i.e. rheumatoid arthritis, lupus, HIV/AIDS < 150 mg/dL
chronic kidney disease Triglyceride
Total cholesterol < 200 mg/dL
Nonmodifiable Risk Factors Medications Lipids
family history of CAD HMG-CoA (Statins)
older age Atorvastatin, lovastatin, pravastatin,
gender (men develop CAD earlier than women) rosuvastatin, simvastatin
race (greater incidence of heart disease in African-American) Nicotinic acid (Niacin/VitB)
history of premature menopause Fibric Acid (Fibrates)
history of pregnancy associated disorders FenoÞbrate, gemÞbrozil, fenoÞbric acid
i.e. preeclampsia Bile acids sequestrants
primary hypercholesteremia Cholestyramine, colestipol, colesevelam
Cholesterol absorption inhibitors
Ezetimibe
Omega acid ethyl ester
