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Review
. 2024 Dec 11;27(1):17.
doi: 10.1007/s11883-024-01262-y.

Risk Factors Favoring Plaque Erosion

Tomoyo Hamana  1 , Palak Shah  1 , Alyssa Grogan  1 , Rika Kawakami  1 , Desiree Williams  1 , Keisha Medina Diaz  1 , Renu Virmani  1 , Aloke V Finn  2   3
Affiliations
Review

Risk Factors Favoring Plaque Erosion

Tomoyo Hamana et al. Curr Atheroscler Rep. .

Abstract

Purpose of review: Plaque erosion is the second leading cause of coronary thrombosis following plaque rupture and represents a key pathophysiological process underlying acute coronary syndromes that can culminate in sudden coronary death. While the precise mechanisms and risk factors driving plaque rupture are well-established, those for erosion have only recently been explored. This review summarizes current literature on the characteristics and risk factors favoring plaque erosion.

Recent findings: Plaque erosion is characterized by a defective endothelial layer in the intima, promoting thrombus formation in the presence of an intact fibrous cap. It is more common in younger women (< 50 years) and smokers. Pathologic intimal thickening or fibroatheroma are common underlying lesions. Risk factors include gender, age, smoking, and disturbances in shear flow. Advances in pathogenic and molecular mechanisms, such as endothelial shear stress, neutrophil activation, and toll-like receptor-2 pathways, are discussed. Understanding the major risk factors for plaque erosion can inform diagnostics and therapeutics to prevent the progression of arterial thrombosis.

Keywords: Acute coronary syndrome; Cardiovascular disease; Coronary thrombosis; Endothelial cells; Risk factors; Sudden cardiac death.

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Conflict of interest statement

Declarations. Human and Animal Rights and Informed Consent: No animal or human subjects by the authors were used in this study. Competing Interests: The authors declare no competing interests.

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