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July 8, 1996

Thrombosis in Ischemic Heart Disease

Author Affiliations

From the Division of Cardiology, Department of Medicine, Mount Sinai Medical Center, New York, NY.

Arch Intern Med. 1996;156(13):1382-1394. doi:10.1001/archinte.1996.00440120032004

Thrombus formation on a fissured or disrupted atherosclerotic plaque is the main pathogenetic mechanism for the acute coronary syndromes of myocardial infarction and unstable angina. Myocardial infarction results from an acute total occlusion of the artery, while unstable angina is secondary in most cases to mural thrombus formation. Thrombus formation has also been implicated in chronic atherosclerotic disease progression and in restenosis following coronary angioplasty. Therapeutic measures to treat thrombus rely on the ability of drugs to either prevent thrombus extension, dissolve its fibrin component, or prevent further platelet aggregation. Other measures rely on the ability of intracoronary techniques to open coronary arteries. The primary prevention of intracoronary thrombus formation is evolving. Measures to stabilize plaques or to reduce hypercoagulability are being tested or have been tested in recent trials.

Arch Intern Med. 1996;156:1382-1394

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