Atherosclerotic Plaque Erosion: Mechanisms, Clinical Implications, and potential therapeutic Strategies - a review

J Cardiovasc Pharmacol. 2024 Feb 29. doi: 10.1097/FJC.0000000000001554. Online ahead of print.

Abstract

Atherosclerosis is an insidious and progressive inflammatory disease characterized by the formation of lipid-laden plaques within the intima of arterial walls with potentially devastating consequences. While rupture of vulnerable plaques has been extensively studied, a distinct mechanism known as plaque erosion has gained recognition and attention in recent years. Plaque erosion, characterized by the loss of endothelial cell lining in the presence of intact fibrous cap contributes to a significant and growing proportion of acute coronary events. However, despite a heterogenous substrate underlying coronary thrombosis, treatment remains identical. This article provides an overview of atherosclerotic plaque erosion characteristics and its underlying mechanisms, highlights its clinical implications, and discusses potential therapeutic strategies.