F00574 018 f059

Early athcrosclerosis

Activated endothelial cells express adhesion mołecules and recruit inflammatory cells. predominantty monocytes- ^^s*****

^L Lipid accumulates in intimal space Abnormal endothelial celi function

Monocytes migrate into intima. differentiate into macrophages and ingest lipid to form foam cells --

Cytokines and growth factors produced by activated macrophages induce smooth muscle celi _

migration into the intima^^₌₌====^e===^

Migrating smooth muscle cells change from contractile to repair phenotype

Advanced atherosclerosis

Stable atherosclerotic plaque

Unstable coronary artery disease

Fibrous cap Intimal smooth (smooth muscle muscle cells cells and matrix) (repair

Endothelial

core

Medial smooth muscle cells Adventitia (contractile phenotype)

Intimal smooth muscle cells become senescent

Activated macrophages induce intimal smooth muscle celi death and degrade matrix in the fibrous cap

Thrombus forms and extends into the lumen and the plague

Platelets aggregate at site of rupture/erosion

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