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In the presence of a constant luminal dimension, there is increasing stress with enlargement of the lipid core. With increasing ﬁbrous cap thickness, even in the presence of a decreasing luminal area, circumferential stress decreases. Another important feature is the lipid core itself, which, because of its semiﬂuid nature, bears very little circumferential stress. , 1992). Frequency of Stress Much like fatigue fractures occurring in metal, the frequency, extent, and localization of stress play important roles in plaque rupture.
Tissue Factor Pathway Inhibitor Tissue factor pathway inhibitor (TFPI) is a protein that circulates bound to lowdensity lipoprotein (LDL) and high-density lipoprotein (HDL). It can inhibit both the VIIa tissue factor complex and factor Xa. In the coagulation cascade, TFPI inhibits the production of factor Xa generated by the extrinsic Xase complex, thus inhibiting clot formation more “proximally” (in the coagulation cascade) than either AT or APC. , 1988) and is released constitutively and following exogenous heparin administration.
Atherosclerosis as an inﬂammatory process: the roles of the monocyte-macrophage. Ann NY Acad Sci 1985;454:115–120. Tirzui D, Bobrain A, Tasca C, Simionescu M, Simionescu N. Intimal thickenings of human aorta contain modiﬁed reassembled lipoproteins. Atherosclerosis 1995;112: 101–114. Virmann R, Koldgie FD, Burke AP, Farb A, Schwartz SM. Lessons from sudden coronary death: a comprehensive morphologic classiﬁcation scheme for atherosclerotic lesions. Arteriocler Thromb Vasc Biol 2000;20:1262–1275.
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