Coronary heart disease risk factors: known and the less known.

ischaemic death is considered, it is the association of thrombosis with atherosclerosis that is paramount. It is important to understand the concepts of ‘plaque’ burden; the average number of plaques in the coronary arteries and the nature of plaques appear to determine the incidence of CHD. The level of inflammatory activity in the plaque makes it vulnerable and may lead to precipitation of thrombotic episode. The plaque disruption involves the mechanical tearing of the fibrous cap of the plaque that has a lipid core. Endothelial erosion is simply a continuation of endothelial denudation that occurs over many plaques and is an important mechanism in diabetic subjects.