Pathogenesis of the acute coronary syndromes and therapeutic implications.

Atherosclerosis is characterized by the thickening and obstruction of the arterial lumen and thrombosis associated with vulnerable disrupted plaques seems to be responsible for the accelerated process of clinical syndrome presentation. Strategies to promote plaque stabilization and reduce thrombus burden have been one of the major targets of recent times. Modification of diet and lifestyle has important benefit in reducing coronary risk. Several pharmacological strategies for reducing cardiovascular morbidity and mortality have demonstrated effectiveness. Statins and angiotensin converting enzyme, fibrinolytics, inhibitors of the intrinsic coagulation cascade and anti-platelet agents have been developed to reduce the impact of atherosclerosis and inhibit thrombogenesis.