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17 - Platelets and atherosclerosis

Published online by Cambridge University Press:  15 October 2009

Meinrad Gawaz
Affiliation:
Medizinische Klinik III, Eberhard Karls-Universität Tübingen, Germany
Paolo Gresele
Affiliation:
Università degli Studi di Perugia, Italy
Valentin Fuster
Affiliation:
Mount Sinai School of Medicine, New York
Jose A. Lopez
Affiliation:
Seattle University
Clive P. Page
Affiliation:
King's College London
Jos Vermylen
Affiliation:
Katholieke Universiteit Leuven, Belgium
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Summary

INTRODUCTION

Atherosclerosis is a chronic inflammatory disease influenced by circulating cells, including platelets. The development of atherosclerotic vessel transformation results from environmental factors, genetics, lifestyle, and chance. Atherosclerosis selectively affects arterial vessels of mainly medium and large size, such as the aorta, coronary vessels, supra-aortic vessels (e.g., the carotid arteries), and large vessels of the lower extremities. The major clinical manifestations are coronary artery disease and myocardial infarction, carotid stenosis or occlusion and stroke, and peripheral arterial occlusive disease.

Aging is usually associated with the advancement of atherosclerosis, since most young people in their twenties already have fatty streak lesions that do not usually lead to any clinical problems. However, in their sixties, most people in the Western Hemisphere have complex atherosclerotic lesions that can cause ischemic or thrombotic events at any time.

To assess the atherosclerotic burden and overall risk for the development of an atherosclerotic disease, cardiologists check for the presence of the classic cardiac risk factors, such as old age, male gender, tobacco smoking, hypertension, hypercholesterolemia, diabetes mellitus, obesity, and a sedentary lifestyle.

Most of these risk factors are associated with one another (e.g., a sedentary lifestyle causes obesity, which causes hypertension and diabetes).

Unfortunately, atherosclerosis usually presents at an advanced stage, before these risk factors become evident to the patient.

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Publisher: Cambridge University Press
Print publication year: 2007

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