Mental stress, atheroma, myocardial ischaemia and injury: the link is inflammation

Figures

• 

  Figure 1. Differences in definition and diagnosis between type 1 and type 2 myocardial infarctions (MIs): acute and chronic myocardial injury*. *Modified from Figure 6, Fourth Universal Definition of Myocardial Infarction. Thygesen et al.2

• 

  Figure 2. Plaque progression, not the percentage of stenosis, determines the clinical event.* With type 1 plaque progression, the stenosis did not change in the first three measurements, but a sudden marked increase was observed between the third and fourth measurements: 71% of the patients developed ACS. With type 2 plaque progression, stenosis increased constantly throughout all intervals: 14% of the patients developed angina. In the control group with no significant plaque progression, no ACS was found: only 2% of the patients developed angina. It is not the degree of stenosis at any one time but the rate of future plaque progression that determines adverse clinical events. *Adapted from Yokoya et al 24 and Ahmadi et al.25 ACS, acute coronary syndrome.

• 

  Figure 3. Inflammation leads to adverse cardiovascular outcomes by causing acute type 1 and type 2 myocardial infarctions (MIs) and myocardial injury.