New insights into atherosclerotic plaque rupture.

Coronary artery atherosclerosis is the major cause of mortality and morbidity in the industrialised world. Progressive narrowing of coronary arteries causes angina. However, it is rupture of the plaque that causes the catastrophic consequences of atherosclerosis, such as myocardial infarction. Recent work has identified that the stability of the plaque rather than its absolute size determines the likelihood of rupture, making a change in plaque composition rather than plaque regression a worthwhile clinical goal. This review summarises recent advances in the understanding of plaque rupture, and identifies areas in which new therapies may be directed.