Stable coronary artery disease: focus on the plaque and hypertriglyceridemia

Abstract

This work deals with new data concerning the pathogenesis of coronary heart disease. Fundamental works and clinical studies report no direct relationships between the severity of coronary artery lesions and the risk of adverse cardiovascular events. Currently more attention is focused on the total extension of atherosclerotic process within coronary arteries as well as morphological features of the plaques. The modern concept of coronary artery disease is constantly moving from the theory of ischemia and lesion severity as key prognostic determinants to morphological and biological changes occuring inside the atherosclerotic plaque which are responsible of the plaque destabilisation and occurrence of acute events. Up to date visualisation modalities capable to distinguish stable and unstable plaques based on their morphological features and to exactly describe high risk plaque. According to the modern total cardiovascular risk concept the patient suffering cardiovascular disease should be treated to achieve target levels of total cholesterol, low density lipoproteid cholesterol, blood pressure, glycaemic profile and other risk factors. But achievement of this target levels doesn’t eliminate the risk completely, residual risk is comprised of prothrombotic factors, systemic inflammation process, lipoproteid (a) and triglycerides levels. The purpose of this work is to analyse relationships between elevated triglycerides levels and atherogenesis including the formation of high risk plaques as well as to overview current pharmacological treatment modalities using omega-3 free fatty acids drugs.