Mechanisms of Acute Coronary Syndromes and Their Implications for Therapy
Abstract
The notion that heart attacks develop from coronary-artery stenosis is an oversimplification of a process involving lipid metabolism, inflammation, macrophage activation, collagen breakdown, and plaque rupture. These insights are leading to new ideas for treatment and prevention.
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A strength of the study is the measurement of lifelong exercise patterns, chosen because atherosclerosis is a lifelong process.
“A strength of our study is how we measured exercise volume. We chose to record lifelong exercise patterns as atherosclerosis is also a lifelong process 49 .”
From Relationship between lifelong exercise volume and coronary atherosclerosis in athletes. (2017) · cites this paper as [49]
Cites
Optimal Medical Therapy with or without PCI for Stable Coronary Disease
Boden, W. E., O'Rourke, R. A., Teo, K. K., Hartigan, P. M., Maron, D. J., Kostuk, W. J., Knudtson, M., Dada, M., Casperson, P., Harris, C. L., et al. (2007) · New England Journal of Medicine · doi:10.1056/nejmoa070829 · Cited by 4,699 · see citing works
Effects of torcetrapib in patients at high risk for coronary events
Barter, P. J., Caulfield, M., Eriksson, M., Grundy, S. M., Kastelein, J. J. P., Komajda, M., Lopez-Sendon, J., Mosca, L., Tardif, J.-C., Waters, D. D., et al. (2007) · New England Journal of Medicine · doi:10.1056/nejmoa0706628 · Cited by 3,139 · see citing works
Niacin in Patients with Low HDL Cholesterol Levels Receiving Intensive Statin Therapy
The AIM-HIGH Investigators (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1107579 · Cited by 2,911 · see citing works
Effects of Combination Lipid Therapy in Type 2 Diabetes Mellitus
(2010) · New England Journal of Medicine · doi:10.1056/nejmoa1001282 · Cited by 2,837 · see citing works
Effects of dalcetrapib in patients with a recent acute coronary syndrome
Schwartz, G. G., Olsson, A. G., Abt, M., Ballantyne, C. M., Barter, P. J., Brumm, J., Chaitman, B. R., Holme, I. M., Kallend, D., Leiter, L. A., et al. (2012) · New England Journal of Medicine · doi:10.1056/nejmoa1206797 · Cited by 2,022 · see citing works
Ridker, P. M., Thuren, T., Zalewski, A., & Libby, P. (2011) · American Heart Journal · doi:10.1016/j.ahj.2011.06.012 · Cited by 799 · see citing works
Self-citationEffect of a Monoclonal Antibody to PCSK9 on LDL Cholesterol
Stein, E. A., Mellis, S., Yancopoulos, G. D., Stahl, N., Logan, D., Smith, W. B., Lisbon, E., Gutierrez, M., Webb, C., Wu, R., et al. (2012) · New England Journal of Medicine · doi:10.1056/nejmoa1105803 · Cited by 664 · see citing works
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Collet, J.-P., Thiele, H., Barbato, E., Barthélémy, O., Bauersachs, J., Bhatt, D. L., Dendale, P., Dorobantu, M., Edvardsen, T., Folliguet, T., et al. (2021) · European Heart Journal · doi:10.1093/eurheartj/ehaa575 · Cited by 5,037 · see citing works
Libby, P., Buring, J. E., Badimon, L., Hansson, G. K., Deanfield, J., Bittencourt, M. S., Tokgözoğlu, L., & Lewis, E. F. (2019) · Nature Reviews Disease Primers · doi:10.1038/s41572-019-0106-z · Cited by 3,211 · see citing works
Self-citationThe changing landscape of atherosclerosis
Libby, P. (2021) · Nature · doi:10.1038/s41586-021-03392-8 · Cited by 2,873 · see citing works
Self-citationChronic variable stress activates hematopoietic stem cells
Heidt, T., Sager, H. B., Courties, G., Dutta, P., Iwamoto, Y., Zaltsman, A., von zur Muhlen, C., Bode, C., Fricchione, G. L., Denninger, J., et al. (2014) · Nature Medicine · doi:10.1038/nm.3589 · Cited by 803 · see citing works
Self-citationMonocyte-macrophages and T cells in atherosclerosis
Tabas, I., & Lichtman, A. H. (2017) · Immunity · doi:10.1016/j.immuni.2017.09.008 · Cited by 646 · see citing works
Rao, S. V., O’Donoghue, M. L., Ruel, M., Rab, T., Tamis-Holland, J. E., Alexander, J. H., Baber, U., Baker, H., Cohen, M. G., Cruz-Ruiz, M., et al. (2025) · Circulation · doi:10.1161/cir.0000000000001309 · Cited by 625 · see citing works
Animal models of atherosclerosis
Emini Veseli, B., Perrotta, P., De Meyer, G. R. A., Roth, L., Van der Donckt, C., Martinet, W., & De Meyer, G. R. Y. (2017) · European Journal of Pharmacology · doi:10.1016/j.ejphar.2017.05.010 · Cited by 548 · see citing works
Metformin and inflammation: its potential Beyond glucose-lowering effect
Saisho, Y. (2015) · Endocrine, Metabolic & Immune Disorders-Drug Targets · doi:10.2174/1871530315666150316124019 · Cited by 450 · see citing works
Burden of Coronary Artery Disease and Peripheral Artery Disease: A Literature Review
Bauersachs, R., Zeymer, U., Brière, J.-B., Marre, C., Bowrin, K., & Huelsebeck, M. (2019) · Cardiovascular Therapeutics · doi:10.1155/2019/8295054 · Cited by 449 · see citing works
Genesis and growth of extracellular-vesicle-derived microcalcification in atherosclerotic plaques
Hutcheson, J. D., Goettsch, C., Bertazzo, S., Maldonado, N., Ruiz, J. L., Goh, W., Yabusaki, K., Faits, T., Bouten, C., Franck, G., et al. (2016) · Nature Materials · doi:10.1038/nmat4519 · Cited by 419 · see citing works
Self-citationFranklin, B. A., Thompson, P. D., Al-Zaiti, S. S., Albert, C. M., Hivert, M.-F., Levine, B. D., Lobelo, F., Madan, K., Sharrief, A. Z., Eijsvogels, T. M. H., et al. (2020) · Circulation · doi:10.1161/cir.0000000000000749 · Cited by 410 · see citing works
Emerging Mechanisms of Cardiovascular Protection for the Omega-3 Fatty Acid Eicosapentaenoic Acid
Mason, R. P., Libby, P., & Bhatt, D. L. (2020) · Arteriosclerosis, Thrombosis, and Vascular Biology · doi:10.1161/atvbaha.119.313286 · Cited by 407 · see citing works
Self-citationRelationship between lifelong exercise volume and coronary atherosclerosis in athletes.
Aengevaeren, V. L., Mosterd, A., Braber, T. L., Prakken, N. H. J., Doevendans, P. A., Grobbee, D. E., Thompson, P. D., Eijsvogels, T. M. H., & Velthuis, B. K. (2017) · Circulation · doi:10.1161/circulationaha.117.027834 · Cited by 309 · see citing works
Toledo, E., Hu, F. B., Estruch, R., Buil-Cosiales, P., Corella, D., Salas-Salvadó, J., Covas, M. I., Arós, F., Gómez-Gracia, E., Fiol, M., et al. (2013) · BMC Medicine · doi:10.1186/1741-7015-11-207 · Cited by 289 · see citing works
Roeseler, E., Julius, U., Heigl, F., Spitthoever, R., Heutling, D., Breitenberger, P., Leebmann, J., Lehmacher, W., Kamstrup, P. R., Nordestgaard, B. G., et al. (2016) · Arteriosclerosis, Thrombosis, and Vascular Biology · doi:10.1161/atvbaha.116.307983 · Cited by 227 · see citing works
The arterial microenvironment: the where and why of atherosclerosis
Yurdagul, A., Finney, A. C., Woolard, M. D., & Orr, A. W. (2016) · Biochemical Journal · doi:10.1042/bj20150844 · Cited by 185 · see citing works
Extracellular matrix proteomics identifies molecular signature of symptomatic carotid plaques
Langley, S. R., Willeit, K., Didangelos, A., Matic, L. P., Skroblin, P., Barallobre-Barreiro, J., Lengquist, M., Rungger, G., Kapustin, A., Kedenko, L., et al. (2017) · Journal of Clinical Investigation · doi:10.1172/jci86924 · Cited by 174 · see citing works
Periodontal therapy and cardiovascular risk
Orlandi, M., Graziani, F., & D'Aiuto, F. (2020) · Periodontology 2000 · doi:10.1111/prd.12299 · Cited by 155 · see citing works
Defective autophagy in atherosclerosis: to die or to senesce?
Grootaert, M. O. J., Roth, L., Schrijvers, D. M., De Meyer, G. R. Y., & Martinet, W. (2018) · Oxidative Medicine and Cellular Longevity · doi:10.1155/2018/7687083 · Cited by 147 · see citing works
Nakashima, H., Kurobe, M., Minami, K., Furudono, S., Uchida, Y., Amenomori, K., Nunohiro, T., Takeshita, S., & Maemura, K. (2015) · European Heart Journal: Acute Cardiovascular Care · doi:10.1177/2048872614530865 · Cited by 71 · see citing works
Koskinas, K. C., Windecker, S., Buhayer, A., Gencer, B., Pedrazzini, G., Mueller, C., Cook, S., Muller, O., Matter, C. M., Räber, L., et al. (2018) · Clinical Cardiology · doi:10.1002/clc.23112 · Cited by 26 · see citing works
Nagasawa, S.-Y., Ohkubo, T., Masaki, K., Barinas-Mitchell, E., Miura, K., Seto, T., El-Saed, A., Kadowaki, T., Willcox, B. J., Edmundowicz, D., et al. (2015) · Journal of Atherosclerosis and Thrombosis · doi:10.5551/jat.23580 · Cited by 26 · see citing works
Liu, Z., Xu, Y., Hao, H., Yin, C., Xu, J., Li, J., Wang, Y., & Xu, D. (2016) · International Journal of Cardiology · doi:10.1016/j.ijcard.2016.07.140 · Cited by 16 · see citing works
Ilardi, F., Gargiulo, G., Schiattarella, G. G., Giugliano, G., Paolillo, R., Menafra, G., De Angelis, E., Scudiero, L., Franzone, A., Stabile, E., et al. (2018) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2018.03.004 · Cited by 16 · see citing works
Hamer, M., Hackett, R. A., Bostock, S., Lazzarino, A. I., Carvalho, L. A., & Steptoe, A. (2014) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2014-000030 · Cited by 12 · see citing works
- Authors
- Libby, P.
- Affiliations
- Brigham and Women's Hospital (US)
- Corresponding author
- Libby, Peter
- ORCID
- Libby, Peter
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2013-05-23
- Volume
- 368
- Issue
- 21
- Pages
- 2004-2013
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2102785524
- Cited by
- 1,262
- References
- 7
- Citations by year
- 2026: 63 · 2025: 70 · 2024: 89 · 2023: 91 · 2022: 95 · 2021: 114 · 2020: 113 · 2019: 101 · 2018: 79 · 2017: 104 · 2016: 120 · 2015: 92 · 2014: 94 · 2013: 34 · 2012: 1
- FWCI
- 9.89
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Immunology and Microbiology › Immunology › Atherosclerosis and Cardiovascular Diseases
- Health Sciences › Medicine › Surgery › Coronary Interventions and Diagnostics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Keywords
- acute coronary syndrome, myocardial infarction, coronary artery stenosis, atherosclerotic plaque rupture, lipid metabolism, inflammation, macrophage activation, collagen degradation, plaque vulnerability, secondary prevention, therapeutic target
- MeSH terms
- Humans, Acute Coronary Syndrome, Plaque, Atherosclerotic
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