[优质文档]动脉硬化血栓病理心理学.pptVIP

Atherothrombosis Pathophysiology;What Is Atherothrombosis?;Atherothrombosis* is theLeading Cause of Death Worldwide1;Atherothrombosis Significantly Shortens Life;3.2 Million Hospital Admissions;Preventable Deaths;* Based on data from the ARIC study of the National Heart, Lung, and Blood Institute, 1987-1994. Includes Americans hospitalized with definite or probable MI or fatal CHD, not including silent MIs.  ACS, acute coronary syndrome; MI, myocardial infarction; ARIC, Atherosclerotic Risk in Communities, CHD, coronary heart disease. American Heart Association. Heart Disease and Stroke Statistics—2003 Update.;Epidemiology of Stroke in the United States;Peripheral Arterial Disease ;Diabetes: Impact in United States;Cerebral Ischemic stroke Transient ischemic attack Cardiac Myocardial infarction Angina pectoris (stable, unstable) Peripheral Arterial Disease Critical limb ischemia, claudication;Overlap of Vascular Disease in Patients With Atherothrombosis;Common Underlying Atherothrombotic Disease Process;Risk of a Second Atherothrombotic Event;UnstableanginaMI Ischemic stroke/TIA Critical legischemia Intermitentclaudication CV death;Atherothrombosis: Thrombus Superimposed on Atherosclerotic Plaque;Characteristics of Unstable and Stable Plaque;Plaque Rupture;Risk Factors for Plaque Rupture;Multiple Risk Factors for Atherothrombosis;Risk Factors for Ischemic Stroke;RCA Wall;Evidence of Multiple “Vulnerable” Plaques in ACS;Multiple Complex Coronary Plaques in Patients With Acute MI;ACS, acute coronary syndrome. Rioufol G, et al. Circulation 2002;106:804-808. (with permission) ;ACS: Tip of the Atherothrombotic “Iceberg”;Hemostatic Plug Formation;Adhesion;GP IIb/IIIa Inhibitors;;Thrombin Serotonin Epinephrine Collagen;Platelet Hyperreactivity Following ACS Predicts 5-Year Outcomes;Platelets Release Inflammatory Mediators and Lead to Vascular Inflammation and Plaque Instability;;Inflammatory Modulators Produced by Platelets;;Heeschen C, et al. N Engl J M