Makindo Medical Notes"One small step for man, one large step for Makindo" |
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Related Subjects: |Atherosclerosis |Ischaemic heart disease |Assessing Chest Pain |ACS - General |ACS - STEMI |ACS - NSTEMI |ACS - GRACE Score |ACS - ECG Changes |ACS -Cardiac Troponins |ACS - Post MI arrhythmias |ACS: Right Ventricular Infarction
Risk factors | |
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Dyslipidaemia (elevated LDL, decreased HDL) | Excess LDL accumulates in the intima and undergoes modifications that initiate and perpetuate the development of atherosclerotic lesions. HDL does not accumulate in vessel walls can even move cholesterol out of arterial walls. |
Tobacco smoking | Enhances oxidative modification of LDL, contributes to endothelial dysfunction via oxidant stress and increases expression of leukocyte adhesion molecules, among other factors |
Hypertension | Increases permeability of vessel wall to lipoproteins. Promotes retention of LDL in the vessel intima by increased production of LDL-binding proteoglycans by Smooth muscle cells |
Diabetes mellitus | Enhances glycation of LDL and is associated with endothelial dysfunction |
Obesity and lack of physical activity | Contribute to dyslipidaemia, hypertension and insulin resistance |
Non-modifiable risk factors | |
Advanced age | Age is a strong risk factor |
Male gender | Lack of atheroprotective properties of oestrogen which raises HDL and lowers LDL |
Heredity | history of coronary artery disease (CAD) among first-degree relatives at a young age (before 55 for males and before 65 for females) |
Biological markers | |
Homocysteine | High levels may promote oxidative stress, vascular inflammation and platelet adhesiveness |
Lipoprotein particle Lp(a) | Detrimental effect may be attributed to competition with normal plasminogen activity |
C-reactive protein and other markers of inflammation | Activates complement and contributes to a sustained inflammatory st |