2004, Número s2
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Arch Cardiol Mex 2004; 74 (s2)
Consecuencias microcirculatorias distales a la placa inestable
Leiva PJL
Idioma: Español
Referencias bibliográficas: 13
Paginas: 257-260
Archivo PDF: 62.24 Kb.
RESUMEN
La ruptura de una placa vulnerable en las arterias coronarias tiene consecuencias funcionales y ultraestructurales a distancias insospechadas, más allá del lugar de localización de la placa. Una de dichas consecuencias es la microembolización distal, otra es la disfunción microvascular. Es aconsejable tomar en consideración un proceso de desestabilización pancoronaria en el planteamiento de una estrategia óptima de los síndromes coronarios agudos.
REFERENCIAS (EN ESTE ARTÍCULO)
Naghavi M, Libby P, Falk E, et al: From vulnerable plaque to vulnerable patient. A call for new definitions and risk assessment strategies: Part I. Circulation 2003; 108: 1164-1672.
Schoenhagen P, Tuzcu M, Ellis SG: Plaque vulnerability, plaque rupture, and acute coronary syndromes. Circulation 2002; 106: 760-762.
Libby P: Current concepts of the pathogenesis of the acute coronary syndromes. Circulation 2001; 104: 365-372.
Rioufol G, Finet G, Ginon I, et al: Multiple atherosclerotic plaque rupture in acute coronary syndrome. A three-vessel intravascular ultrasound study. Circulation 2002; 106: 804-808.
Kuroda N, Kobayashi Y, Mintz GS, et al: Multiple ruptured plaques. Serial intravascular ultrasound examinations. Circulation 2003; 108: 131-132.
Goldstein JA, Demetriou D, Grines CL, Pica M, Shoukfeh M, O´Neill WW: Multiple complex coronary plaques in patients with acute myocardial infarction. N Engl J Med 2000; 343: 915-922.
Burke AP, Kolodgie FD, Farb A, et al: Healed plaque ruptures an sudden coronary death. Evidence that subclinical rupture has a role in plaque progression. Circulation 2001; 103: 934-940.
Cannon CP, Turpie AG: Unstable angina and non-ST-elevation myocardial infarction. Initial antithrombotic therapy and early invasive strategy. Circulation 2003; 107: 2640-2645.
Henriques JP, Zijlstra F, Van‘t Hof AW, et al: Angiographic assessment of reperfusion in acute myocardial infarction by myocardial blush grade. Circulation 2003; 107: 2115-2119.
Topol EJ, Yadav JS: Recognition of the importance of embolization in atherosclerotic vascular disease. Circulation 2000; 101: 570-580.
Nissen SE: Pathobiology, not angiography, should guide management in acute coronary syndrome/non-ST-segment elevation myocardial infarction. J Am Coll Cardiol 2003; 41: 103S-112S.
Chan AW, Bhatt DL, Chew DP, et al: Relation of inflammation and benefit of statins after percutaneous coronary interventions. Circulation 2003; 107: 1750-1756.
Buffon A, Biasucci LM, Luizzo G, D´Onofrio G, Crea F, Maseri A: Widespread coronary inflammation in unstable angina. N Engl J Med 2002; 347: 5-12.