Atherosclerotic Plaque Rupture

The idiom “the straw that breaks the camel’s back” describes scenarios where seemingly minor incidents eventuate in a sudden, unexpected, and often detrimental downfall. In the case of atherosclerosis, over time multiple subclinical cellular events result in the development of unstable, vulnerable atherosclerotic lesions, which leads to the rupture of atherosclerotic plaques, culminating in the often catastrophic clinical manifestation of myocardial infarction or ischemic stroke. In this review, we first summarize lessons learned from autopsy studies, clinical investigations, and animal models mainly published in ATVB. We then present recent experimental studies published in ATVB that shed light on the underlying pathophysiological development of plaque instability and disruption, and how differential and sometimes maladaptive responses at cellular levels contribute to this complex process. These many publications in ATVB are a testament to the journal’s leading role in research on atherosclerotic plaque instability, an area of research with utmost translational relevance.