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This volume explores the role free radicals and antioxidants within the development of vascular disease, examining fundamental research and translating preclinical knowledge to clinical trials. The expertly authored chapters describe the relationship of oxidative stress to atherosclerosis and the cardiovascular system, exploring its role in cardiac fibrosis, renovascular disease, hypertension, and regulation of blood pressure and cerebral vascular tone. The concluding chapter discusses the current state of clinical research, contextualizing clinical trials within the existing theoretical framework and analyzing attempts to preserve oxidant stress under various conditions. With its concise and authoritative analysis of pre-clinical research and clinical results, Studies in Atherosclerosis – part of the bestselling Oxidative Stress in Basic Research and Clinical Practice series – is essential for researchers and clinicians focusing in cardiology, nephrology, or oxidative stress.

Intracranial atherosclerosis is a leading cause of stroke in Asians and Africans. As these ethnic groups account for more than 70% of the world's population, it is in fact the major cause of ischemic stroke worldwide. This timely book provides readers with up-to-date knowledge of intracranial atherosclerosis, covering vascular anatomy, pathology, epidemiology, stroke mechanisms and syndromes, diagnostic methods as well as treatment strategies such as antithrombotics, angioplasty/stenting and surgery. Furthermore, nonatherosclerotic intracranial arterial diseases like Moyamoya disease, dissection, vasculitis and other miscellaneous disorders are extensively discussed. Experts from both East and West present the latest findings from cutting-edge research and discuss controversial topics from different yet balanced points of view, allowing readers to form their own unbiased opinion on these issues. With this approach, the book serves as a useful and stimulating guide on the diagnosis and management of intracranial atherosclerosis for neurologists, neurosurgeons, neuroradiologists and vascular interventionists.

Atherothrombosis refers to the coupling of atherosclerosis and thrombosis, and it is the leading cause of the majority of preventable deaths in the modern world. The medical, economic, social, and societal consequences or atherothrombosis are enormous, which make it a dynamic area for development of new pharmacologic agents. Atherothrombosis in Clinical Practice focuses upon the many clinical manifestations of atherothrombosis and therapies that presently exist, with a focus on evolving therapeutic approaches. First, atherothrombosis is defined and the epidemiology is explored. Then, the specific manifestations of atherothrombosis (coronary artery disease, valvular heart disease, cerebrovascular disease, atrial fibrillation, peripheral artery disease) are concisely covered by distinguished experts in the field. Next, specific medications are discussed, with an emphasis on innovative therapies and investigational agents including experimental lipid-modifying, anti-inflammatory, antiplatelet, and anticoagulant agents. State-of-the-art treatment of hypertension and diabetes is described succinctly. Lifestyle modification, medical therapies, and where appropriate, invasive modalities are discussed. Controversies in areas such as cholesterol management and glycemic control are summarized. Part of the Oxford American Cardiology Library, this handbook provides a practical, evidence-based summary of the condition and the most up-to-date research to equip clinicians in managing this common clinical problem.

Occult atherosclerotic diseases impose great challenges in the cardiovascular practice. Although their pathology is not much different from that of the overt group of diseases, the clinical approach to their diagnoses remains a puzzle. This has mainly emerged as a result of the problems faced in trying to pick up the vulnerable subjects from among the general public. More definitive candidates to be evaluated are those belonging to one of the high risk groups. There are no statistical figures available on the incidence of occult atherosclerotic disease in the'non risky'general public and this is definitely an area that needs further investigation. Atherosclerotic disease whether they are in the cerebral, coronary, renal or lower limb arteries are theoretically interrelated because the basic patho­ logical changes are usually similar. However there still remain some differ­ ences which are mainly due to variation in the flow pattern in the arteries. Thus it will be important clinically and from the management point of view to investigate for the presence of occult disease in other arteries if an atherosclerotic disease in a certain artery has been discovered. This approach is of a great significance especially from the preventive point of view in order to avoid catastrophic events which may have resulted from pathology in the other region.

The prevalence of coronary artery disease is increasing due to rising rates of obesity and the fact that a greater number of people are living longer. Coronary Atherosclerosis: Current Management and Treatment addresses this leading cause of death worldwide. Atherosclerosis has a broad range of disease manifestations depending on the degree of the stenosis and the functional status of the coronary plaque. This volume, written by a leading international team of editors, addresses the pathophysiology of the disease, established and novel diagnostic approaches (both invasive and non-invasive), treatment methodologies (including treatment algorithms), and differing perspectives on treatment, including future therapies and long-term outcomes. The inclusion of personal perspectives from experts, full-color images and ancillary video files make this a key resource. Key topics include: Pharmacology of coronary artery disease (CAD) Up-to-date evidence on pathophysiology Invasive and non-invasive imaging Current evidence for risk stratification Clinical decisionmaking Coronary Atherosclerosis: Current Management and Treatment provides a state-of-the-art review of current knowledge to aid specialists, general physicians, and cardiologists in training, in the diagnosis, risk stratification, and management of patients with diverse presentations of coronary atherosclerosis.

Proceeding of the 6th International Meeting, Bologna, Italy.

Atherosclerosis is a degenerative process affecting blood vessels, which determines narrowing of the lumen, plaque growth, and hardening of the walls. It is a risk factor for cardiovascular diseases. The focus of this book is on the management of the atherosclerotic disease. The coverage of this book spans from histological presentation of the various stages of atherosclerotic lesions to the earliest studies in atherosclerosis therapy, from advanced clinical diagnosis to monitoring, follow-up, and home-care of the atherosclerotic patient. The book shows well-established diagnostic techniques covering several medical imaging modalities such as Ultrasounds, IVUS, MRI, Computer Tomography, along with new trends in early and advanced atherosclerosis diagnosis (innovative drugs and tissue characterization procedures). Surgical standards will be presented along with innovative experimental trials for the treatment of the atherosclerotic patient. The book will also cover emerging techniques based on molecular imaging and vibro-acoustics.

Despite recent advances in the diagnosis and treatment of symptomatic atherosclerosis, available traditional screening methods for early detection and treatment of asymptomatic coronary artery disease are grossly insufficient and fail to identify the majority of victims prior to the onset of a life-threatening event. In Asymptomatic Atherosclerosis: Pathophysiology, Detection and Treatment, Dr. Morteza Naghavi and leading authorities from the Society for Heart Attack Prevention and Eradication (SHAPE) present a new paradigm for the screening and primary prevention of asymptomatic atherosclerosis. The text focuses on accurate, yet underutilized, measures of subclinical atherosclerosis, notably coronary artery calcium scanning and carotid intima-media thickness measurement. The authors introduce a comprehensive approach to identifying the vulnerable patients (asymptomatic individuals at risk of a near future adverse event). Additional chapters discuss future directions towards containing the epidemic of atherosclerotic cardiovascular disease using innovative solutions such as preemptive interventional therapies (bioabsorbable stents) for stabilization of vulnerable atherosclerotic plaques, mass unconditional Polypill therapy for population-based risk reduction, and ultimately vaccination strategies to prevent the development of atherosclerosis. Up-to-date and authoritative, Asymptomatic Atherosclerosis: Pathophysiology, Detection, and Treatment is a must-have for any cardiologist or primary care physician who wishes to practice modern preventive cardiology and manage the increasing number of asymptomatic atherosclerotic patients. Outlines more accurate measures of risk (coronary artery calcium and carotid intima-media thickness) than traditional risk factors (total cholesterol, LDL cholesterol, HDL cholesterol) Presents new multipronged strategies to aid in the early detection and treatment of high risk asymptomatic patients

Atherosclerosis is a chronic inflammatory disease that affects medium and large-sized arteries. It begins after birth and the progression depends on several factors – traditional triad: hypertension, hyperlipidemia and diabetes mellitus, then age, sex, smoking and sedentary life-style. At the beginning atherosclerosis is asymptomatic and we cannot estimate appropriately its frequency, but its complications – coronary artery diseases, cerebrovascular diseases, peripheral arterial diseases, which occur late, are responsible for more than half of the yearly mortality in the world. Unfortunately, sudden cardiac death may be the first clinical manifestation. The incipient event is endothelial dysfunction, as a result of injury, caused by high level of cholesterol [especially w-density-lipoprotein LDL], hyperglycemia, hypertension, smoking, infectious agents, and toxins. Endothelial cells overexpress adhesion molecules – vascular cell adhesion molecule–1 [VCAM-1] and increases recruitment of inflammatory cells– monocytes [Mo], T-cells and subsequent release of monocyte chemo–attractant protein–1 [MCP-1] that results in additional leucocytes recruitment. Injured endothelium allows migration of inflammatory cells that release cytokines and lipids into the intima. That leads to cytokine-mediated progression of atherosclerosis and oxidation of LDL. Macrophages [MP] take up oxi-LDL and form foam-cell. They have metabolic activity and produce cytokines, proliferation of smooth muscle cells and formulate athero-fibrose plaque. Atherosclerotic plaque is composed of superficial layer – fibrose cap and lipid core, that consists of foam cells, extracellular lipid and necrotic cellular debris. It progresses as a result of accumulation of lipid and proliferation of smooth muscle cells and results in luminal narrowing of the arteries which leads to compromised blood and oxygen supply to the tissues. The gradually growing atherosclerotic plaques have thick fibrose cap and are stable. They cause symptoms of stable angina. Rapidly growing plaques cause unstable coronary artery disease. These plaques are mainly composed of lipids and have tiny fibrose cap that is prone to fissuring or rupture. Intraplaque hemorrhage from microvessels in plaque initiate platelet adhesion and activation of coagulation cascade that leads to platelet thrombus formation, i.e. promote thrombogenesis. Knowledge of the pathogenesis of the atherothrombosis modifies the diagnostic and therapeutic approach. Conclusion: Attention should be focused on the management of three points: 1. Endothelial dysfunction [correction of modified risk factors: hypertension, hyperlipidemia, diabetes mellitus, life-style-smoking, physical activity and food], 2. Atherosclerosis [modification of the inflammatory cascade, i.e. elimination of inflammatory pathways and inhibition of oxidation of LDL], 3. Thrombogenesis [inhibition of platelet adhesion, activation and aggregation].

During the twentieth century we saw a veritable revolution in medicine. Some of the most notable advances have been in the elucidation of the risk factors for and treatment of cardio- and cerebral vascular disease. Identifying these factors through epidemiological studies has led to the development of guidelines for a healthy life style and therapies to control this major killer of the elderly. As a result of these efforts at the present time cardiovascular disease, rather than being the leading cause of death in the United States, has dropped to second behind cancer. Beginning with such seminal studies as the Seven Countries study and the Framingham program, these major advances have resulted from a collaboration among several disciplines, including epidemiology, clinical trials, cell biology, and basic biochemistry. The combined? ndings from these disparate disciplines have served as the foundation for the institution of public health measures, such as smoking cessation campaigns and new dietary recommendations, as well as the development of medications to prevent disease through the control of such major risk factors as hypertension and hyperlipidemia. One of the major insights into the underlying cause of vascular injury is that it is initiated by oxidant injury to the vessel wall. The current volume is - ganized around the role of oxidant damage in this disease process.

Finally, a convenient, one-volume summary of current knowledge on an area of increasing importance! The Vulnerable Atherosclerotic Plaque presents contributions from the best investigators in the field, skillfully edited for easy reading and lavishly illustrated with high-quality, full-color images. After a considered and concise introduction, the book concentrates on: Pathology of vulnerable plaque Triggers for plaque rupture Imaging of unstable plaque Management of vulnerable plaques Careful editing allows the authors to avoid repetition and provide comprehensive coverage of pathology, detection, and management. This thorough and authoritative reference will change the way interventionists look at the disease.

Dr Shor believes it is important for every medical practitioner to be aware of the new aspects of this disease, and that all facts concerning the circumstances, the finding of the germ, the specific pathological features and other aspects which change the concept of heart attacks, remarkably, methods of diagnoses of the lesion should all be known. Details and facets of the lesion are necessary for assessment, acceptance or rejection of this very important new disease, by the scientific community. It opens up new diagnosis and treatments, with potential cure and eradication of this deadly disease. Immunization or eradication of this germ if possible will open new horizons.

Today, in the era of the statins (cholesterol lowering drugs), there is no longer any doubt about the value of lowering blood cholesterol levels. The Cholesterol Wars chronicles the controversy that swirled around the'lipid hypothesis'of atherosclerosis for so many years. In fact,'the lower the better'is the position of many clinicians. However, getting to this point has been a long uphill battle marked by heated debate and sometimes violent disagreement. The history of this controversy is told here for its own sake and because remembering it may help us avoid similar mistakes in the future. Dr. Steinberg and his colleagues have published over 400 papers relating to lipid and lipoprotein metabolism and atherosclerosis reflecting the prominence these authors have in the community Chronicles the miraculous power of the statins to prevent heart attacks and save lives, of great interest to the many manufacturers of these drugs Discusses new targets for intervention based on a better understanding of the molecular basis of atherosclerosis

Chronic oxidative stress is associated with the aging process and often leads to the development of disorders such as cancer and arterial disease. Cardiovascular conditions in which oxidation damage has been strongly implicated include atherosclerosis, myocardial ischemia and reperfusion, coronary restenosis, diabetes mellitus, and congestive heart failure. Antioxidants and Cardiovascular Disease, Second Edition covers three major topics: 1) the first seven chapters review the oxidative modifcation hypothesis and its close relationship to lipid metabolism and to the pathogenesis of atherosclerosis; 2) the next four chapters describe the different compounds, nutrients and supplements with antioxidant properties and their mechanisms of action; 3) and finallly, the last ten chapters discuss the potential benefits of antioxidants in overall cardiovascular prevention, including hypertension, diabetes mellitus, dyslipidemias, and in the treatment and prevention of specific conditions such as chronic coronary artery disease, restenosis after percutaneous coronary intervention, and chronic heart failure. Antioxidants and Cardiovascular Disease, Second Edition is written by recognized experts in the fields of atherosclerosis, heart failure and antioxidants. It should be of interest to medical students and fellows, researchers, and practicing physicians. There has been rapid progress in our knowledge in this field during the last two to three years. Thus the current reedition appears timely. For instance, this second edition captures several recently reported and published clinical trials as welll as new information on diabetic and hypertensive cardiovascular disease.

Atherosclerosis is the most common cardiovascular disorder in western societies and is rapidly becoming similarly prevalent in the underdeveloped world. Written by notable authorities and providing text rich in illustrative figures, Molecular Mechanisms in Atherosclerosis addresses the fundamental mechanisms underlying atherothrombosis and delineat

Cardiovascular diseases continue to be the leading cause of death in the - jority of industrialized countries. The most frequent underlying pathology, namely atherosclerosis, and its clinical sequelae, namely coronary heart d- ease, cerebrovascular disease and peripheral artery disease, remain common although for a long time we have been made aware of avoidable or mo-?able etiological factors such as smoking, fat-rich diet or lack of exercise, and although these adverse lifestyle factors have been extensively addressed by population-wide primary prevention programs. Cardiovascular morbidity and mortality also remain high despite successful anti-hypertensive and lipid lowering drug therapies which help to reduce cardiovascular morbidity and mortality by about 30% in both secondary and tertiary prevention settings. This can partly be explained by the increasing life expectancy and growing p- portionofelderly people,especiallyinEuropeandNorthAmerica. Inaddition, the World Health Organization makes the alarming prediction that probably in response to the spreading of western dietary behavior and lack of exercise resulting in an increasing prevalence of diabetes, dyslipidemia and hypert- sion, cardiovascular diseases rather than infectious diseases will become the most frequent cause of death worldwide. This volume of the Handbook of Experimental Pharmacology entitled “Atherosclerosis” is divided into four parts and intends to give an overview on the pathogenesis of atherosclerosis, established treatment and prevention regimen, and of perspectives for the development of new treatment modalities.

Exploring the entire range of recent advances, Atherosclerosis and Heart Disease covers all aspects of atherosclerotic disease, including chronic manifestations, bypass surgery, stroke prevention and methods to lower blood pressure. Professor Tonkin brings together a team of internationally-recognized experts to discuss sound clinical practices, based on scientific research and publications. They examine conventional and novel risk factors, acute coronary syndromes, and chronic manifestations of disease. The book provides a broad perspective on the disease process as it affects the patients doctors see every day and outlines current therapeutic strategies.

This latest edition of the Lipids and Atherosclerosis Annual includes chapters on topics of current interest, including the long-term safety of lipid-lowering drugs and the implications of statin therapy on CHD prevention.

Given the continuing development of new statins and their increasing, beneficial use in clinical practice and given the importance of clinical research into the atherosclerotic plaque and its role in cardiovascular and endovascular diseases, given the immense advances in animal and human studies that have taken place over the past few years at a st