Cited by 548Coronary Interventions and DiagnosticsAtherosclerosis and Cardiovascular DiseasesCerebrovascular and Carotid Artery Diseases

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Pathophysiology of native coronary, vein graft, and in-stent atherosclerosis

Yahagi, Kazuyuki, Kolodgie, Frank D., Otsuka, Fumiyuki, Finn, Aloke V., Davis, Harry R., Joner, Michael, Virmani, Renu·2016·Nature Reviews Cardiology

DOI 10.1038/nrcardio.2015.164

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Abstract

Plaque rupture, usually of a precursor lesion known as a 'vulnerable plaque' or 'thin-cap fibroatheroma', is the leading cause of thrombosis. Less-frequent aetiologies of coronary thrombosis are erosion, observed with greatest incidence in women aged <50 years, and eruptive calcified nodules, which are occasionally identified in older individuals. Various treatments for patients with coronary artery disease, such as CABG surgery and interventional therapies, have led to accelerated atherosclerosis. These processes occur within months to years, compared with the decades that it generally takes for native disease to develop. Morphological identifiers of accelerated atherosclerosis include macrophage-derived foam cells, intraplaque haemorrhage, and thin fibrous cap. Foam-cell infiltration can be observed within 1 year of a saphenous vein graft implantation, with subsequent necrotic core formation and rupture ensuing after 7 years in over one-third of patients. Neoatherosclerosis occurs early and with greater prevalence in drug-eluting stents than in bare-metal stents and, although rare, complications of late stent thrombosis from rupture are associated with high mortality. Comparison of lesion progression in native atherosclerotic disease, atherosclerosis in saphenous vein grafts, and in-stent neoatherosclerosis provides insight into the pathogenesis of atheroma formation in natural and iatrogenic settings.

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Authors: Yahagi, K., Kolodgie, F. D., Otsuka, F., Finn, A. V., Davis, H. R., Joner, M., & Virmani, R.
Affiliations: CVPath Institute (US)
Emory University Hospital (US)
Corresponding author: Virmani, Renu
ORCID: Yahagi, Kazuyuki
Kolodgie, Frank D.
Otsuka, Fumiyuki
Finn, Aloke V.
Davis, Harry R.
Joner, Michael
Virmani, Renu
Venue: Nature Reviews Cardiology
Publisher: Springer Science and Business Media LLC
Published: 2015-10-27
Volume: 13
Issue: 2
Pages: 79-98
ISSN: 1759-5002 (ISSN-L)
1759-5010
DOI: 10.1038/nrcardio.2015.164
OpenAlex: W2264045234
Cited by: 548
References: 122
Citations by year: 2026: 29 · 2025: 41 · 2024: 70 · 2023: 56 · 2022: 62 · 2021: 59 · 2020: 70 · 2019: 50 · 2018: 49 · 2017: 36 · 2016: 24
FWCI: 6.96
Type: journal article
Language: en
Open access: closed
Licence: www.springer.com/tdm (tdm)
Locations: Nature Reviews Cardiology (publishedVersion)
PubMed (publishedVersion)
mediaTUM – the media and publications repository of the Technical University Munich (Technical University Munich) (submittedVersion)
Funders: National Institute of Diabetes and Digestive and Kidney Diseases (R01DK094434)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Coronary Interventions and Diagnostics
Life Sciences › Immunology and Microbiology › Immunology › Atherosclerosis and Cardiovascular Diseases
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cerebrovascular and Carotid Artery Diseases
Keywords: coronary artery disease, vein graft atherosclerosis, in-stent neoatherosclerosis, premature atherosclerosis, atherosclerotic plaque morphology, plaque rupture, vulnerable plaque, thin-cap fibroatheroma, coronary thrombosis, plaque erosion, saphenous vein graft, drug-eluting stents, bare-metal stents, stent thrombosis, intraplaque hemorrhage, foam cells
MeSH terms: Coronary Artery Bypass, Coronary Artery Disease, Humans, Saphenous Vein, United States, Incidence, Prevalence, Survival Rate, Disease Progression, Coronary Restenosis, Drug-Eluting Stents, Plaque, Atherosclerotic

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Pathophysiology of native coronary, vein graft, and in-stent atherosclerosis

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