What is the clinical evidence from this study?

Study design: Review. Population: Atherothrombosis.

What question did this study set out to answer?

Review the cellular and molecular mechanisms driving atherothrombosis and assess modern classification frameworks for high-risk vulnerable coronary plaques.

September 20, 2026Journal of the American College of CardiologyOpen Access

Atherothrombosis and High-Risk Plaque

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Key result

Atherothrombosis progresses via lipid accumulation, inflammation, and thrombosis toward plaque rupture and erosion.

Why the study?

The American Heart Association classification does not include thin cap fibroatheroma or plaque erosion, necessitating new classifications for high-risk plaques in atherothrombosis.

Key Points

Review the cellular and molecular mechanisms driving atherothrombosis and assess modern classification frameworks for high-risk vulnerable coronary plaques.
Synthesized histological and clinical criteria regarding plaque vulnerability, highlighting gaps in the traditional American Heart Association classification.
Evaluated molecular mechanisms across five continuous phases of plaque evolution, spanning from early endothelial dysfunction to acute thrombosis.
Identified that conventional classification models omit critical high-risk phenotypes, notably thin-cap fibroatheroma and plaque erosion.
Characterized lesion progression across five phases governed by impaired cholesterol clearance, Toll-like receptor immune signaling, calcification, and vasa vasorum neovascularization.
Demonstrated that focal and circulating tissue factor from apoptotic macrophages and monocytes provides the direct pathophysiological bridge between vascular inflammation and occlusive thrombosis.

PICO

Population

Atherothrombosis

Discussion

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Implication

This review provides a comprehensive overview of the pathophysiology of atherothrombosis and high-risk plaques, emphasizing the need for updated histologic classifications.

Cite This Study

Fuster et al. (2005) conducted a review in Atherothrombosis. Atherothrombosis is a complex disease driven by cholesterol deposition, inflammation, and thrombus formation, with plaque rupture and erosion leading to acute coronary events.

synapsesocial.com/papers/6ab04d16cdc128587b47ec99 https://doi.org/10.1016/j.jacc.2005.03.074

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Implication

This review provides a comprehensive overview of the pathophysiology of atherothrombosis and high-risk plaques, emphasizing the need for updated histologic classifications.

Atherothrombosis and High-Risk Plaque

Key Points

PICO

Discussion

Implication

Cite This Study

Atherothrombosis and High-Risk Plaque

Key Points

PICO

Discussion

Implication

Cite This Study

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