ABSTRACT
Thrombosis plays a central role in the pathogenesis of the acute ischemic syndromes and the complications of percutaneous coronary revascularization. Rupture of atherosclerotic plaque initiates thrombosis and occurs spontaneously in the acute ischemic syndromes or is induced by percutaneous revascularization devices. Plaque rupture exposes thrombogenic subendothelial components, which leads to platelet aggregation and initiation of the coagulation cascade. Propagation of thrombus may lead to partial or complete arterial occlusion and end-organ ischemia or infarction. Moreover, platelet-thrombus formation may be important in the progression of stable atherosclerotic plaque. In addition to cellular migration and proliferation, episodic plaque rupture, thrombus formation, and incorporation of thrombus into the plaque may contribute to gradual, step-wise progression of arterial lumen compromise. Antithrombotic agents are therefore integral to management strategies for acute and chronic coronary artery disease.
