Atherosclerosis: an inflammatory disease.

Inflammation plays a pivotal role in both the development of atherosclerosis and the acute activation of the vascular wall with consequent local thrombosis and vasoconstriction (with or without plaque fissure). In many patients with unstable angina and acute myocardial infarction, systemic signs of inflammation are detectable. The use of systemic inflammatory markers, such as C-reactive protein as marker of disease activity and short- and long-term prognosis, seems to be of clinical value. Therefore, acute inflammatory reaction, detectable systematically, appears to be an independent determinant of prognosis in some patients with acute ischemic syndromes, but is not detectable in all. Understanding the causes of inflammation and the additional elusive components that result in the progression to aggressive acute coronary syndromes, is the future goal of cardiology.