Key Words Atherosclerosis, thrombosis, statins, fibrinolytics, heparin, anti-platelet agents, atherosclerotic plaque, unstable angina, myocardial infarction. Abstract Atherosclerosis is characterized by the thickening and obstruction of the arterial lumen and thrombosis asso- ciated with vulnerable disrupted plaques seems to be responsable for the accelerated process of clinical sin- drome presentation. Strategies to promote plaque stabilization and reduce thrombus burden have been one of the major targets of recent times. Modification of diet and lifestyle has important benefit in reducing coronary risk. Several pharmacological strategies for reducing cardiovascular morbidity and mortality have demonstrated effective- ness. Statins and angiotensin converting enzyme, fibri- nolitics, inhibitors of the intrinsic coagulation cascade and anti-platelet agents have been developed to reduce the impact of atherosclerosis and inhibit thrombogene- sis. Introduction Atherosclerotic disease is a focal pathological phenomena characterized by the thickening and obstruction of the arterial lumen. Epidemiological, clinical and experimental studies have identified several risk factors that are relevant in patients with atherosclerotic disease. Thrombosis on vulnerable high risk plaques is the major trigger of acute ischemic events in the coronary, cerebral and peripheral arterial circulation. Endothelial dysfunction is one of the initial targets and Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com © 2002 S. Karger AG. Basel 1424-8832/02/0326-0225$18.50/0 Accessibile online at: www.karger.com/journals/pht Prof. Lina Badimon CIC / CSIC Jordi Girona, 18-26 - 08034 Barcelona, Spain Tel: 34 93 400 61 46 Fax: 34 93 204 59 04 e-mail : lbmucv@cid.csic.es Copyright © 2002 S. Karger AG. Basel Pathogenesis of the acute coronary syndromes and therapeutic implications L. Badimon 1 ; J.J. Badimon 2 ; G. Vilahur 1 ; E. Segalés 1 ; V. Llorente 1 1 Cardiovascular Research Center, ICCC-CSIC, Hospital de la Santa Creu i Sant Pau, Barcelona (Spain) and 2 Cardiovascular Institute, Mount Sinai Medical Center, New York, (USA) Pathophysiol Haemost Thromb, 2002;32:225-231 Fig. 1. Simplified diagram of atherosclerotic plaque development.